Epidemiology of Antituberculosis Drug Resistance in Saudi Arabia: Findings of the First National Survey

Al‐Hajoj, Sahal; Varghese, Bright; Shoukri, Mohammed; Al-Omari, Ruba; Al-Herbwai, Mais; Alrabiah, Fahad; Alrajhi, Abdulrahman A.; Abuljadayel, Naila; Althawadi, Sahar; Zumla, Alimuddin; Zignol, Matteo; Raviglione, Mario; Memish, Ziad A.

doi:10.1128/aac.02403-12

Cited by 52 publications

(79 citation statements)

References 13 publications

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“…For Saudi Arabia, WHO estimated that 1.4%-2.4% of new TB cases and nearly 10.8% of previously treated TB cases were MDR-TB [1]. Data retrieved from published studies of Saudi Arabia demonstrated that the pattern of resistance and prevalence rate of MDR-TB in last 10 years was 4.3% of the total infected population (Table 2); however, earlier studies reported ~5.5% MDR-TB before 2000 [16] and 4% more recently [4]. There exists a strong proof-based opinion that the present status of MDR-TB in Saudi Arabia is a result of historic clones of tubercle bacilli undergoing active circulation, and also of the huge migration of people from TB-endemic countries.…”

Section: Discussionmentioning

confidence: 87%

“…A few small-scale studies were conducted in Saudi Arabia and reported that proportions of resistance to any first-line drugs were in the range of 14% to 20%, and for MDR-TB were in the range of 1% to 44% [4,10]. These findings must be treated with full caution, as these studies were not representative of the entire country, and most were retrospective analyses of laboratory results collected from hospitals, medical colleges, and primary healthcare centers.…”

Section: Introductionmentioning

confidence: 86%

“…The compositions of the populations of all GCC countries are unique for two reasons: nearly one-third of their population are immigrant workers, and in Saudi Arabia, nearly 10 million foreigners visit the country every year for Islamic rituals (i.e., Hajj and Umrah) [10]. It has already been established that the epidemiology of TB infection is clearly influenced by immigration and mass gatherings [4,10]. Few review articles studying the prevalence rates of drug-resistant TB were published from Saudi Arabia.…”

Section: Introductionmentioning

confidence: 99%

“…Overall treatment success was 48%, whereas 28% of cases were reported as lost to follow-up or had no information regarding their outcomes [1]. Al-Hajoj et al (2013) reported that among a subset of 200 XDR-TB patients in 14 countries, the overall treatment success was 33%, and 26% of cases resulted in death, which indicated poor treatment success rate against drug resistance [1,4]. Similarly, in the year 2010, 3.4% of all newly diagnosed and 19.8% of all previously treated TB cases were evidenced to have MDR-TB [5].…”

Section: Introductionmentioning

confidence: 99%

“…Presently, six Middle Eastern countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates) are the member states of GCC, and few more are trying to become a part of the GCC [6][7][8]. In all GCC countries, the real burden of drug-resistant TB is not known, as these countries (with the exception of Saudi Arabia) have never conducted a representative national-level survey to estimate the prevalence and patterns of anti-TB drugresistance [4].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Prevalence of drug resistance in clinical isolates of tuberculosis from GCC: a literature review from January 2002 to March 2013

Areeshi

Bisht

Mandal

et al. 2014

J Infect Dev Ctries

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Introduction: The prevalence of drug resistance in clinical isolates of Mycobacterium tuberculosis from the Gulf Cooperation Council (GCC; Saudi Arabia, Qatar, Bahrain, Kuwait, Oman, United Arab Emirates [UAE]) countries was appraised using reports published between January 2002 and March 2013. Methodology: A total of 11,393 tuberculosis (TB) isolates from the GCC were studied through published literature and were analyzed statistically. Results: Most of the isolates were resistant to isoniazid, followed by streptomycin, rifampin, ethambutol, and pyrazinamide. The highest prevalence rate of multidrug-resistant-TB (MDR-TB) was found in UAE (9.2%), followed by Kuwait (5.9%) and Saudi Arabia (4.3%). The overall MDR-TB prevalence rate was recorded as 4.0% in the entire GCC region. Automated linear modeling revealed that isoniazid resistance had a strong relationship with the prevalence of MDR-TB in all the GCC countries and was found to be the strongest predictor for MDR-TB. Interestingly, rifampicin resistance was significantly associated with the prevalence of MDR-TB in Oman, Kuwait, and Saudi Arabia, while isoniazid was identified for UAE. On the basis of a number of reports and isolates, the principal component analysis showed that, among all GCC member countries, the highest burden of TB was in Saudi Arabia and Kuwait, and maximum drug resistance was present in UAE. Conclusion: The study demonstrates that the prevalence of MDR-TB in GCC countries is almost equal to other developing and developed countries, and requires immediate attention for surveillance and control.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence of drug resistance in clinical isolates of tuberculosis from GCC: a literature review from January 2002 to March 2013

Areeshi

Bisht

Mandal

et al. 2014

J Infect Dev Ctries

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Drugs behind the veil of Islam: a view of Saudi youth

Jiang

Tang

Jiang

2021

Crime Law Soc Change

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Insufficient research exists on drug trafficking and abuse in Saudi Arabia. This paper aims to uncover how drugs are trafficked to Saudi Arabia, what factors contribute to an ever-growing drug use in the Kingdom, and what the life of illegal drug use looks like in such an Islamic environment. Documentary methods and in-depth interviews were adopted to associate drug problems with social environments. It is discovered that drug trafficking is correlated to economic disparity among regions and social strata in the Kingdom, methods of drug purchase differ regionally, and drug use is an unintended consequence of social changes. The study concludes that drug offenses, countering traditional associations of Saudi society, creates a double life in the Kingdom.

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Tuberculosis and mass gatherings—opportunities for defining burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage

Zumla

Saeed

Alotaibi

et al. 2016

International Journal of Infectious Diseases

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Tuberculosis (TB) is now the most common infectious cause of death worldwide. In 2014, an estimated 9.6 million people developed active TB. There were an estimated three million people with active TB including 360000 with multidrug-resistant TB (MDR-TB) who were not diagnosed, and such people continue to fuel TB transmission in the community. Accurate data on the actual burden of TB and the transmission risk associated with mass gatherings are scarce and unreliable due to the small numbers studied and methodological issues. Every year, an estimated 10 million pilgrims from 184 countries travel to the Kingdom of Saudi Arabia (KSA) to perform the Hajj and Umrah pilgrimages. A large majority of pilgrims come from high TB burden and MDR-TB endemic areas and thus many may have undiagnosed active TB, sub-clinical TB, and latent TB infection. The Hajj pilgrimage provides unique opportunities for the KSA and the 184 countries from which pilgrims originate, to conduct high quality priority research studies on TB under the remit of the Global Centre for Mass Gatherings Medicine. Research opportunities are discussed, including those related to the definition of the TB burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage. The associated data are required to develop international recommendations and guidelines for TB management and control at mass gathering events.

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Epidemiology of Antituberculosis Drug Resistance in Saudi Arabia: Findings of the First National Survey

Cited by 52 publications

References 13 publications

Prevalence of drug resistance in clinical isolates of tuberculosis from GCC: a literature review from January 2002 to March 2013

Prevalence of drug resistance in clinical isolates of tuberculosis from GCC: a literature review from January 2002 to March 2013

Drugs behind the veil of Islam: a view of Saudi youth

Tuberculosis and mass gatherings—opportunities for defining burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage

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