Multidrug-Resistant Tuberculosis, Somalia, 2010–2011

Sindani, Ireneaus; Fitzpatrick, Christopher; Falzon, Dennis; Suleiman, Bashir M.; Arube, Peter; Ismail, Adam; Baghdadi, Samiha; Bassili, Amal; Zignol, Matteo

doi:10.3201/eid1903.121287

Cited by 34 publications

(43 citation statements)

References 5 publications

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“…On the other hand, a higher frequency (27.7%) of monoresistance to any one of the four first-line drugs was reported in another study conducted in the country [20]. INH monoresistance (6.3%) recorded by the present study was comparable to that reported by studies conducted in other African countries such as the Central African Republic [21] and Somalia [22], which reported 5.8 and 5.7% respectively. In an eastern Ethiopian study [11], 9.5% monoresistance to INH was recorded.…”

Section: Discussionsupporting

confidence: 63%

Mycobacterium tuberculosis in central Ethiopia: drug sensitivity patterns and association with genotype

Bedewi

Mekonnen

Worku³

et al. 2017

New Microbes and New Infections

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Drug resistance tuberculosis (TB) and the emergence of multidrug resistant (MDR) isolates are significant concerns regarding TB control programs in several countries. This study was undertaken to evaluate the drug sensitivity of Mycobacterium tuberculosis and to assess its association with strains and lineages of M. tuberculosis.A total of 279 M. tuberculosis strains isolated from Central Ethiopia were tested for their drug sensitivity patterns to first line TB drugs using the conventional proportion method on Löwenstein Jensen media. The association between drug sensitivity and strain type was assessed on 263 isolates of the 279 isolates.Of the 268 M. tuberculosis isolates obtained from new cases, 209 (78%) were susceptible to first line TB drugs, and 59 (22.2%) bacterial isolates were resistant to at least one of the first line drugs. The highest mono-resistance (7.5%) pertained to streptomycin (STM). Remarkably, seven of eleven isolates (63.6%) previous treatment for TB were resistant to at least one of the first line drugs. The prevalence of MDR-TB was 1.5% (4/268) for newly identified TB cases, all of which were members of the Euro-American Lineage. There was no statistically significant association (P > 0.05) between drug sensitivity, and either strains, sub-lineages or main lineages of M. tuberculosis.A significant proportion of M. tuberculosis was resistant to at least one first line anti-TB drug. Moreover, the frequencies of resistance to either isoniazid or rifampicin were high compared to data that were previously reported in some part of the country.

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Section: Discussionsupporting

confidence: 63%

Mycobacterium tuberculosis in central Ethiopia: drug sensitivity patterns and association with genotype

Bedewi

Mekonnen

Worku³

et al. 2017

New Microbes and New Infections

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“…The conflict and violence, particularly in the south-central region, have caused massive population movements, exacerbated recently by severe drought, floods, and famine. The rates of maternal mortality and death in children < 5 years of age are among the highest in the world, and communicable diseases are the most common causes of illness and death [8]. In addition to TB [6, 8], advanced malignancies [9] are a serious public health problem.…”

Section: Discussionmentioning

confidence: 99%

“…Resistance to anti-TB drugs is considered an emerging problem, although the prevalence of multidrug-resistant TB (i.e., resistance to rifampin and isoniazid, the 2 most powerful anti-TB drugs) is unknown [24]. Somalia has an estimated TB rate of 10 per 100,000 inhabitants and a minimum number of 1,000 cases per year, and multidrug resistance has been documented [6].…”

Section: Discussionmentioning

confidence: 99%

Cytological Findings of Malignant and Benign Head and Neck Masses in Somalia

Baş

2018

Acta Cytologica

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Objective: There are no up-to-date records on head and neck masses (HNMs) in Somalia. This cytological study is the first to demonstrate the benefits and findings of fine-needle aspiration cytology in evaluating HNMs in the adult population of Somalia. Study Design: A total of 116 aspiration samples were taken from different levels of the neck region, except for the thyroid. Cases were classified as salivary gland, lymph node, or soft tissue/cystic lesions. They were classified according to age, gender, and cytological diagnosis. Results: Patients included 54 (46.6%) males and 62 (53.4%) females, with a mean age of 40.6 years. Seventy-two patients (62.1%) had benign lesions, while 44 (37.9%) had malignant lesions. Necrotizing granulomatous lymphadenitis (n = 51, 70.8% of the benign findings) and lymph node metastasis of squamous cell carcinoma (n = 13, 29.5% of the malignant findings) were the most frequent findings. Conclusion: Fine-needle aspiration is a useful procedure in the diagnosis of neck masses. It is a cheap and easy guiding method for diagnosing granulomatous lymphadenitis and advanced-stage metastatic cancers, which are common in this country.

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“…Estimates show that 56% these MDR-TB patients have been successfully treated in the Eastern Mediterranean Region, and despite better outcomes compared to other regions, this number is much lower than WHO's defined goal of 75% for 2015 [37] . Country-specific studies highlight the urgent need for addressing MDR-TB, specifically among patients who are re-treated with anti-TB drugs [38][39][40] . The situation is becoming especially critical in Saudi Arabia due to high influence of travelers and migrating laborers from TB endemic areas, and also in Somalia which reports the highest prevalence of MDR-TB in the region [41,42] .…”

Section: Bridging Populationsmentioning

confidence: 99%

Early initiation of antiretroviral treatment: Challenges in the Middle East and North Africa

Sardashti

Samaei

Firouzeh

et al. 2015

WJV

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New World Health Organization guidelines recommend the initiation of antiretroviral treatment (ART) for asymptomatic patients with CD4+ T-cell counts of ≤ 500 cells/mm 3 . Substantial reduction of human immunodeficiency virus (HIV) transmission is addressed as a major public health outcome of this new approach. Middle East and North Africa (MENA), known as the area of controversies in terms of availability of comprehensive data, has shown concentrated epidemics among most of it's at risk population groups. Serious challenges impede the applicability of new guidelines in the MENA Region. Insufficient resources restrict ART coverage to less than 14%, while only one fourth of the countries had reportable data on patients' CD4 counts at the time of diagnosis. Clinical guidelines need to be significantly modified to reach practical utility, and surveillance systems have not yet been developed in many countries of MENA. Based on available evidence in several countries people who inject drugs and men who have sex with men are increasingly vulnerable to HIV and viral hepatitis, while their sexual partners -either female sex workers or women in monogamous relationships with high-risk men -are potential bridging populations that are not appropriately addressed by regional programs. Research to monitor the response to ART among the mentioned groups are seriously lacking, while drug resistant HIV strains and limited information on adherence patterns to treatment regimens require urgent recognition by health policymakers. Commitment to defined goals in the fight against HIV, development of innovative methods to improve registration and reporting systems, monitoring and evaluation of current programs followed by costeffective modifications are proposed as effective steps to be acknowledged by National AIDS Programs of the countries of MENA Region. 134 MINIREVIEWSSubmit a

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Multidrug-Resistant Tuberculosis, Somalia, 2010–2011

Cited by 34 publications

References 5 publications

Mycobacterium tuberculosis in central Ethiopia: drug sensitivity patterns and association with genotype

Mycobacterium tuberculosis in central Ethiopia: drug sensitivity patterns and association with genotype

Cytological Findings of Malignant and Benign Head and Neck Masses in Somalia

Early initiation of antiretroviral treatment: Challenges in the Middle East and North Africa

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