Drug resistance patterns of Mycobacterium tuberculosis complex and associated factors among retreatment cases around Jimma, Southwest Ethiopia

Abdella, Kedir; Abdissa, Ketema; Kebede, Wakjira; Abebe, Gemeda

doi:10.1186/s12889-015-1955-3

Cited by 47 publications

(81 citation statements)

References 17 publications

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“…The highest proportion of Gene Xpert positive M. tuberculosis cases were seen in the age group of 18–30 years. This is consistent with previous reports in Ethiopia [20–22, 26]. This might be due to more exposure to the outer environment, high work load and wide range of mobility of young people to acquire the TB bacilli as young people have.…”

Section: Discussionsupporting

confidence: 92%

“…In this study, high prevalence of rifampicin-resistant M. tuberculosis was detected among HIV positive cases which are in accordance with a study done in other part of Ethiopia [26] and Cambodia [44]. However, in the present study, there was a lack of association between HIV infection and development of active tuberculosis as well as rifampicin resistance.…”

Section: Discussionsupporting

confidence: 91%

“…In the present study, the proportion of rifampicin-resistant M. tuberculosis was significantly higher among previously treated patients compared to treatment naive patients which might be due to failure from previous treatment and contact with drug resistant TB patients [26, 38–43]. However, the level of rifampicin resistance among previously untreated cases (6.7%) in the analysis close to the reported prevalence of rifampicin- resistant MTB (10.4%).…”

Section: Discussionsupporting

confidence: 68%

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Rifampicin-resistance pattern of Mycobacterium tuberculosis and associated factors among presumptive tuberculosis patients referred to Debre Markos Referral Hospital, Ethiopia: a cross-sectional study

et al. 2017

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BackgroundPrevailing data on rifampicin-resistant M. tuberculosis is essential for early management of MDR-TB. Therefore, this study was conducted to determine the prevalence of rifampicin-resistant Mycobacterium tuberculosis and associated factors among presumptive TB cases in Debre Markos Referral Hospital, Ethiopia.MethodsA cross-sectional study was conducted from September 2014 to March 2015. Detection of M. tuberculosis and resistance to rifampicin was performed using Gene Xpert MTB/RIF assay. Data was collected using structured questionnaire by face to face interview. Logistic regression analysis was computed to determine the associated factors of rifampicin-resistant M. tuberculosis.ResultsA total of 505 presumptive TB patients included in the study. The prevalence of M. tuberculosis confirmed cases was 117 (23.2%) (95% CI 19.7–27%). It was higher among males (27.9%) than females (17.9%) (AOR: 2.17; CI 1.35–3.49). Of the 117 M. tuberculosis confirmed cases, 12 (10.3%) (95% CI 6.0–17.1%) were resistant to rifampicin. Rifampicin-resistant M. tuberculosis was noticed in 7 previously treated TB patients (17.1%) and 5 treatment naive patients (6.7%) (AOR: 4.16; CI 1.04–16.63). The prevalence of rifampicin-resistant M. tuberculosis was 6 (9.8%) and 6 (11.3%) in pulmonary and extra-pulmonary infections, respectively. Of the 30, MTB/HIV co-infection, 3 (10%) were rifampicin-resistant M. tuberculosis.ConclusionRifampicin-resistant M. tuberculosis is prevalent in both pulmonary and extra-pulmonary tuberculosis patients. Previous treatment with anti-TB drugs was significantly associated with rifampicin resistance. Therefore, the use of Gene Xpert should be scaled up across the country for rapid detection and management of drug resistant M. tuberculosis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 68%

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Rifampicin-resistance pattern of Mycobacterium tuberculosis and associated factors among presumptive tuberculosis patients referred to Debre Markos Referral Hospital, Ethiopia: a cross-sectional study

et al. 2017

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“…Such patients are also more likely to be noncompliant to TB treatment and hence linked with drug-resistant TB [31]. Multidrug-resistant (MDR-TB) poses a threat to TB control worldwide, and globally an estimated 3.5% (95% CI: 2.2–4.7%) of new cases and 20.5% (95% CI: 13.6–27.5%) of previously treated cases have MDR-TB.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Mortality among Patients on TB Treatment in the Southern Region of Zimbabwe, 2013

Takarinda

Sandy

Masuka

et al. 2017

Tuberculosis Research and Treatment

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Background. In 2013, the tuberculosis (TB) mortality rate was highest in southern Zimbabwe at 16%. We therefore sought to determine factors associated with mortality among registered TB patients in this region. Methodology. This was a retrospective record review of registered patients receiving anti-TB treatment in 2013. Results. Of 1,971 registered TB patients, 1,653 (84%) were new cases compared with 314 (16%) retreatment cases. There were 1,538 (78%) TB/human immunodeficiency virus (HIV) coinfected patients, of whom 1,399 (91%) were on antiretroviral therapy (ART) with median pre-ART CD4 count of 133 cells/uL (IQR, 46–282). Overall, 428 (22%) TB patients died. Factors associated with increased mortality included being ≥65 years old [adjusted relative risk (ARR) = 2.48 (95% CI 1.35–4.55)], a retreatment TB case [ARR = 1.34 (95% CI, 1.10–1.63)], and being HIV-positive [ARR = 1.87 (95% CI, 1.44–2.42)] whilst ART initiation was protective [ARR = 0.25 (95% CI, 0.22–0.29)]. Cumulative mortality rates were 10%, 14%, and 21% at one, two, and six months, respectively, after starting TB treatment. Conclusion. There was high mortality especially in the first two months of anti-TB treatment, with risk factors being recurrent TB and being HIV-infected, despite a high uptake of ART.

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“…The isolates for this study were recovered from the TB patients who were included in the drug resistance survey around Jimma among new and retreatment cases (Abdella, Abdissa, Kebede, & Abebe, ; Abebe et al, ). The stored isolates were subcultured, and 179 isolates were recovered (115 from the study among new cases (Abebe et al, ) and 64 from the study on retreatment cases (Abdella et al, )). They were inactivated at 80°C for 1 hr and transported to Aklilu Lemma Institute of Pathobiology, Addis Ababa University, for spoligotyping using 43 spacer version.…”

Section: Methodsmentioning

confidence: 99%

Spoligotype‐based population structure of Mycobacterium tuberculosis in the Jimma Zone, southwest Ethiopia

et al. 2018

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Background To understand the population dynamics and propose more effective preventive strategies, defining the population structure of the circulating Mycobacterium tuberculosis strains is important. Methods A total of 177 M. tuberculosis complex isolates from pulmonary tuberculosis (TB) cases in southwest Ethiopia were genotyped by spoligotyping. Of the strains included in this study, 126 were pan‐susceptible strains while the remaining 51 isolates were resistant to one or more first‐line anti‐TB drugs. The genotyping results were compared to the international spoligotyping (SITVIT) database of the Pasteur Institute of Guadeloupe and the newly revised publicly available international multi‐marker database (SITVITWEB/SPOLDB4). An online tool Run TB‐Lineage was also used to predict the major lineages using a conformal Bayesian network analysis. Results The spoligotyping of the 177 isolates resulted in 69 different spoligotype patterns of which 127 (71.8%) were clustered into 19 spoligoclusters (with clustering rate of 61.02%). Each cluster contains 2–29 isolates. Of the isolates with corresponding SIT in SITVIT/SDB4, the predominant strains identified were SIT 37 of the T3 subfamily with 29 isolates followed by SIT 53 of the T1 subfamily with 20 isolates. SIT 777 of the H4 subfamily and SIT 25 of the CAS1_DELHI subfamily each consisting of six isolates were identified. Eighty spoligotype patterns were orphan as they were not recorded in the SITVIT2/SPDB4 database. Further classification of the isolates on the basis of major lineages showed that 82.5% and 14.1% of the isolates belonged to Euro‐American and East African Indian lineages, respectively, while 2.8% of the isolates belonged to Mycobacterium africanum and 0.6% to Indo‐Oceanic. Conclusion The ill‐defined T and H clades were predominant around Jimma. The substantial number of orphans recorded in the study area warrants for additional studies with genotyping methods with better resolution and covering whole areas of southwest Ethiopia.

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Drug resistance patterns of Mycobacterium tuberculosis complex and associated factors among retreatment cases around Jimma, Southwest Ethiopia

Cited by 47 publications

References 17 publications

Rifampicin-resistance pattern of Mycobacterium tuberculosis and associated factors among presumptive tuberculosis patients referred to Debre Markos Referral Hospital, Ethiopia: a cross-sectional study

Rifampicin-resistance pattern of Mycobacterium tuberculosis and associated factors among presumptive tuberculosis patients referred to Debre Markos Referral Hospital, Ethiopia: a cross-sectional study

Factors Associated with Mortality among Patients on TB Treatment in the Southern Region of Zimbabwe, 2013

Spoligotype‐based population structure of Mycobacterium tuberculosis in the Jimma Zone, southwest Ethiopia

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