Multidrug-resistant tuberculosis in Burkina Faso from 2006 to 2017: Results of national surveys

Abstract

Setting A survey of the prevalence of drug-resistant tuberculosis (DR-TB) in new and previously treated patients (PTPs) was performed in Burkina Faso from 2016 to 2017. Design In this cross-sectional survey, a structured questionnaire was administered to eligible smear-positive patients in all 86 diagnostic and treatment centers of the country to collect their socio-demographic characteristics and medical histories. Their sputa were tested using the Mycobacterium tuberculosis/rifampicin (MTB/RIF) Xpert assay. Those which were found to be positive for TB and rifampicin-resistant were also tested with GenoType MTBDRplus2.0 and MTBDRsl2.0. Univariate and multivariate logistic regressions were performed to determine risk factors associated with rifampicin resistance. Results Of the 1140 smear-positive patients enrolled, 995 new and 145 PTPs were positive for MTB complex by Xpert. Of these, 2.0% (20/995, 95% confidence interval (CI): 1.1–2.9) of the new cases and 14.5% (95% CI: 14.2–20.2) of the PTPs were resistant to rifampicin; 83% of them has multidrug-resistant tuberculosis (MDR-TB). None were pre-extensively drug-resistant TB (pre-XDR-TB) or XDR-TB. Only the previous treatment was significantly associated with rifampicin resistance, p < 0.0001. Conclusion Similar to global trends, rifampicin resistance was significantly higher in patients with prior TB treatment (14.5%) than in naïve patients (2.0%). These percentages are slightly below the global averages, but nonetheless suggest the need for continued vigilance. Extending the use of Xpert testing should strengthen the surveillance of DR-TB in Burkina Faso.

The burden of drug resistance tuberculosis in Ghana; results of the First National Survey

“…For example, in Uganda, lower rates of 1.4% and 12.1% among new and previously treated patients were recorded during their national TB drug-resistant survey [ 17 ]. In nearby Burkina Faso, levels of 3.4% in new cases similar to what we detected, but very high levels in previously treated patients (50.5%) have been reported [ 19 ]. Similarly, in Côte d’Ivoire, the proportion of patients with rifampicin resistance was estimated to be 4.6% (95% CI: 2.4–6.7) and 22% (95% CI: 13.7–30.3), respectively, for new and previously treated patients [ 20 ].…”

<p>Prevalence of Tuberculosis by Automated GeneXpert Rifampicin Assay and Associated Risk Factors Among Presumptive Pulmonary Tuberculosis Patients at Ataye District Hospital, North East Ethiopia</p>

“…32 Similarly, in the current study, only one study subject developed RR-TB. Several studies in Ethiopia 7,8,15 and elsewhere 33,34 indicated that a history of previous TB treatment had strong association with the development of PTB and MDR-TB; whereas in the present study it was not associated with PTB. On the other hand, like the current study, there were reports that showed sex, residence, education, 14 previous history of TB, and HIV serostatus 10 were insignificant variables.…”

Molecular Detection of Drug-Resistant Mycobacterium tuberculosis in Sputum Specimens from the New and Previously Treated Tuberculosis Cases at the National Reference Chest Diseases Laboratory in Lusaka, Zambia

“…A similar study conducted in Zimbabwe found the prevalence of RR to be 4.0% among the new TB cases and 14.2% among the previously treated TB cases [53], while a South-African found the burden of RR to be 8.8% among the previously treated TB cases [54]. In Burkina Faso, the prevalence of RR was found at 2.0% and 14.5% among the new and previously treated TB cases, respectively [55]. RR-TB is associated with a history of being treated for TB previously.…”

“…MDR-TB is one of the most serious public health problems in the world [55,62]. Its prevalence is increasing in every part of the world today, for both new and previously treated TB cases [63].…”