The second national anti‐tuberculosis drug resistance survey in Tanzania, 2017–2018

Abstract

Objective To determine the levels and patterns of resistance to first‐ and second‐line anti‐tuberculosis (TB) drugs among new and previously treated sputum smear positive pulmonary TB (PTB) patients. Methods We conducted a nationally representative cross‐sectional facility‐based survey in June 2017–July 2018 involving 45 clusters selected based on probability proportional to size. The survey aimed to determine the prevalence of anti‐TB drug resistance and associated risk factors among smear positive PTB patients in Tanzania. Sputum samples were examined using smear microscopy, Xpert MTB/RIF, culture and drug susceptibility testing (DST). Logistic regression was used to account for missing data and sampling design effects on the estimates and their standard errors. Results We enrolled 1557 TB patients, including 1408 (90.4%) newly diagnosed and 149 (9.6%) previously treated patients. The prevalence of multidrug‐resistant TB (MDR‐TB) was 0.85% [95% confidence interval (CI): 0.4–1.3] among new cases and 4.6% (95% CI: 1.1–8.2) among previously treated cases. The prevalence of Mycobacterium tuberculosis strains resistant to any of the four first‐line anti‐TB drugs (isoniazid, rifampicin, streptomycin and ethambutol) was 1.7% among new TB patients and 6.5% among those previously treated. Drug resistance to all first‐line drugs was similar (0.1%) in new and previously treated patients. None of the isolates displayed poly‐resistance or extensively drug‐resistant TB (XDR‐TB). The only risk factor for MDR‐TB was history of previous TB treatment (odds ratio = 5.7, 95% CI: 1.9–17.2). Conclusion The burden of MDR‐TB in the country was relatively low with no evidence of XDR‐TB. Given the overall small number of MDR‐TB cases in this survey, it will be beneficial focusing efforts on intensified case detection including universal DST.

Resistance Rates of Mycobacterium tuberculosis Complex Isolates to Primary Anti-tuberculosis Drugs: A 5-Year Retrospective Study

“…However the ratio differs from the results obtained by Quezel-Guerraz et al and Al-Shahrani et al (21,22), stating that TB has a higher incidence in men due to greater exposure to the surrounding, alcohol-abusing and other factors that may constitute a risk to acquire the bacterium. Despite many studies in the literature have reported that tuberculosis is common among young people (22)(23)(24)(25), in our study the vast majority of TB cases were in the age group 56-75 years (42.2%), With aging, many elements can play a crucial role in acquiring TB such as suppressed immune system due to drugs or other conditions, higher tendency to respiratory diseases, and activation of latent TB infection. The most frequent clinical manifestation of TB infections was pulmonary TB 139 (90.3%) while extrapulmonary cases were only 15 (9.7%), in accordance with many previous literature (12,13,(25)(26)(27).…”

Multidrug-resistant tuberculosis: latest opinions on epidemiology, rapid diagnosis and management

“…Only primary quantitative studies were selected from the search output. The title of the study, year of study, study setting, study design, MDR-TB confirmed number of cases, MDR-TB/HIV co-infection proportion, and the outcome explored were characteristics retrieved from the studies (Table 1 ) [ 9 – 13 , 14 ▪▪ , 15 – 21 , 22 ▪▪ , 23 , 24 ▪▪ , 25 – 29 , 30 ▪ , 31 ▪ , 32 – 36 , 37 ▪▪ , 38 – 48 , 49 ▪▪ , 50 ▪ ].…”

Apport Du Genexpert MTB/Rif Dans La Detection De L’infection a Mycobacterium Tuberculosis Et La Resistance a La Rifampicine a L’hopital General De Reference De Kirungu-Moba, Sud-Est De La Republique Democratique Du Congo

“…Abdoulaye et al [57] Niger (Maradi) 2022 20,0 Farra et al [58] RCA (Bangui) 2023 22,5 Monde et al [34] Zambie (Sud) En Zambie, la résistance à la rifampicine varie de 2,66 -3,0% au Sud [34], [48] à 3,0 -32% au Nord [54], avec des pics dans la région de Copperbelt. Dans une étude nationale tanzanienne regroupant les données de 2017 à 2018, Mutayoba et al [44] soulignent que la Tanzanie est le pays africain avec faible prévalence de la résistance aux médicaments antituberculeux en Afrique : la mono-résistance à la rifampicine est de 0,3% pour tous les patients et 0,1% pour les cas incidents ; Mbeya (3,4%), Unguja (2,4%) et Dar Es Salam (1,9%) sont les régions les plus affectées. Les faibles prévalences ont été également rencontrées au Kenya : aucun cas de TB-RR parmi 132 cas de tuberculose [43]; 6,7% parmi les séropositifs de la région de Kisumu, réputée à forte prévalence du VIH/SIDA [62]; et 15,6% dans les régions du Nord comprenant Vilhiya, Kisumu et Nyamira [53].…”