The second national anti‐tuberculosis drug resistance survey in Tanzania, 2017–2018
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–...
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| Veröffentlicht in: | Tropical medicine & international health 2022-10, Vol.27 (10), p.891-901 |
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| creator | Mutayoba, Beatrice Kemilembe Ershova, Julia Lyamuya, Eligius Hoelscher, Michael Heinrich, Norbert Kilale, Andrew Martin Range, Nyagosya Segere Ngowi, Benard James Ntinginya, Nyanda Elias Mfaume, Saidi Mwinjuma Nkiligi, Emmanuel Doulla, Basra Lyimo, Johnson Kisonga, Riziki Kingalu, Amri Lema, Yakobo Kondo, Zuwena Pletschette, Michel |
| description | 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. |
| doi_str_mv | 10.1111/tmi.13814 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9826299</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2720221244</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4434-a0fb4d0edbe590355c2045d81de70b52e4f94577e48a5b301a9abe37d1b76ada3</originalsourceid><addsrcrecordid>eNp1kd9qFDEUh4Motm698AVkwJsKnW3-TmZuBClaCxVvtvQynJmc3U2ZTWoy07Je9REE37BPYrZbFxWam3NIvnyc5EfIG0anLK_jYeWmTNRMPiP7TFSqFExVzx96WnKuqz3yKqUrSqmUqnpJ9vJ-3SjN98nlbIlFwi54W3gYXPDQF-AHd3_3cxhbjN3Yh-RSYeO4KCLmdgDf5TtjvMF14XwxA_8DvIOjglOm7-9-5VIfkBdz6BO-fqwTcvH50-zkS3n-7fTs5ON52UkpZAl03kpL0baoGiqU6jiVytbMoqat4ijnjVRao6xBtYIyaKBFoS1rdQUWxIR82Hqvx3aFtkM_ROjNdXQriGsTwJl_T7xbmkW4MU3NK940WXD4KIjh-4hpMCuXOux78BjGZLhmQtBKig367j_0Kowxf9iG4pRzxvOjJuT9lupiSCnifDcMo2YTl8lxmYe4Mvv27-l35J98MnC8BW5dj-unTWb29Wyr_A0YGaC1</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2720221244</pqid></control><display><type>article</type><title>The second national anti‐tuberculosis drug resistance survey in Tanzania, 2017–2018</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><creator>Mutayoba, Beatrice Kemilembe ; Ershova, Julia ; Lyamuya, Eligius ; Hoelscher, Michael ; Heinrich, Norbert ; Kilale, Andrew Martin ; Range, Nyagosya Segere ; Ngowi, Benard James ; Ntinginya, Nyanda Elias ; Mfaume, Saidi Mwinjuma ; Nkiligi, Emmanuel ; Doulla, Basra ; Lyimo, Johnson ; Kisonga, Riziki ; Kingalu, Amri ; Lema, Yakobo ; Kondo, Zuwena ; Pletschette, Michel</creator><creatorcontrib>Mutayoba, Beatrice Kemilembe ; Ershova, Julia ; Lyamuya, Eligius ; Hoelscher, Michael ; Heinrich, Norbert ; Kilale, Andrew Martin ; Range, Nyagosya Segere ; Ngowi, Benard James ; Ntinginya, Nyanda Elias ; Mfaume, Saidi Mwinjuma ; Nkiligi, Emmanuel ; Doulla, Basra ; Lyimo, Johnson ; Kisonga, Riziki ; Kingalu, Amri ; Lema, Yakobo ; Kondo, Zuwena ; Pletschette, Michel</creatorcontrib><description>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.</description><identifier>ISSN: 1360-2276</identifier><identifier>EISSN: 1365-3156</identifier><identifier>DOI: 10.1111/tmi.13814</identifier><identifier>PMID: 36089572</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Antitubercular Agents - pharmacology ; Antitubercular Agents - therapeutic use ; Confidence intervals ; Cross-Sectional Studies ; Drug resistance ; Drugs ; Ethambutol ; Extensively Drug-Resistant Tuberculosis - diagnosis ; Extensively Drug-Resistant Tuberculosis - drug therapy ; Extensively Drug-Resistant Tuberculosis - microbiology ; Humans ; Isoniazid ; Isoniazid - therapeutic use ; MDR‐TB ; Microbial Sensitivity Tests ; Missing data ; Multidrug resistance ; Mycobacterium tuberculosis ; Patients ; Polls & surveys ; Resistance factors ; Rifampin ; Rifampin - therapeutic use ; Risk analysis ; Risk factors ; Sampling designs ; Sputum ; Statistical analysis ; Streptomycin ; Streptomycin - therapeutic use ; survey ; Surveys ; Tanzania ; Tanzania - epidemiology ; Tuberculosis ; Tuberculosis, Multidrug-Resistant - drug therapy ; Tuberculosis, Multidrug-Resistant - epidemiology ; Tuberculosis, Multidrug-Resistant - microbiology</subject><ispartof>Tropical medicine & international health, 2022-10, Vol.27 (10), p.891-901</ispartof><rights>2022 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4434-a0fb4d0edbe590355c2045d81de70b52e4f94577e48a5b301a9abe37d1b76ada3</citedby><cites>FETCH-LOGICAL-c4434-a0fb4d0edbe590355c2045d81de70b52e4f94577e48a5b301a9abe37d1b76ada3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftmi.13814$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftmi.13814$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36089572$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mutayoba, Beatrice Kemilembe</creatorcontrib><creatorcontrib>Ershova, Julia</creatorcontrib><creatorcontrib>Lyamuya, Eligius</creatorcontrib><creatorcontrib>Hoelscher, Michael</creatorcontrib><creatorcontrib>Heinrich, Norbert</creatorcontrib><creatorcontrib>Kilale, Andrew Martin</creatorcontrib><creatorcontrib>Range, Nyagosya Segere</creatorcontrib><creatorcontrib>Ngowi, Benard James</creatorcontrib><creatorcontrib>Ntinginya, Nyanda Elias</creatorcontrib><creatorcontrib>Mfaume, Saidi Mwinjuma</creatorcontrib><creatorcontrib>Nkiligi, Emmanuel</creatorcontrib><creatorcontrib>Doulla, Basra</creatorcontrib><creatorcontrib>Lyimo, Johnson</creatorcontrib><creatorcontrib>Kisonga, Riziki</creatorcontrib><creatorcontrib>Kingalu, Amri</creatorcontrib><creatorcontrib>Lema, Yakobo</creatorcontrib><creatorcontrib>Kondo, Zuwena</creatorcontrib><creatorcontrib>Pletschette, Michel</creatorcontrib><title>The second national anti‐tuberculosis drug resistance survey in Tanzania, 2017–2018</title><title>Tropical medicine & international health</title><addtitle>Trop Med Int Health</addtitle><description>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.</description><subject>Antitubercular Agents - pharmacology</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>Confidence intervals</subject><subject>Cross-Sectional Studies</subject><subject>Drug resistance</subject><subject>Drugs</subject><subject>Ethambutol</subject><subject>Extensively Drug-Resistant Tuberculosis - diagnosis</subject><subject>Extensively Drug-Resistant Tuberculosis - drug therapy</subject><subject>Extensively Drug-Resistant Tuberculosis - microbiology</subject><subject>Humans</subject><subject>Isoniazid</subject><subject>Isoniazid - therapeutic use</subject><subject>MDR‐TB</subject><subject>Microbial Sensitivity Tests</subject><subject>Missing data</subject><subject>Multidrug resistance</subject><subject>Mycobacterium tuberculosis</subject><subject>Patients</subject><subject>Polls & surveys</subject><subject>Resistance factors</subject><subject>Rifampin</subject><subject>Rifampin - therapeutic use</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Sampling designs</subject><subject>Sputum</subject><subject>Statistical analysis</subject><subject>Streptomycin</subject><subject>Streptomycin - therapeutic use</subject><subject>survey</subject><subject>Surveys</subject><subject>Tanzania</subject><subject>Tanzania - epidemiology</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Multidrug-Resistant - drug therapy</subject><subject>Tuberculosis, Multidrug-Resistant - epidemiology</subject><subject>Tuberculosis, Multidrug-Resistant - microbiology</subject><issn>1360-2276</issn><issn>1365-3156</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kd9qFDEUh4Motm698AVkwJsKnW3-TmZuBClaCxVvtvQynJmc3U2ZTWoy07Je9REE37BPYrZbFxWam3NIvnyc5EfIG0anLK_jYeWmTNRMPiP7TFSqFExVzx96WnKuqz3yKqUrSqmUqnpJ9vJ-3SjN98nlbIlFwi54W3gYXPDQF-AHd3_3cxhbjN3Yh-RSYeO4KCLmdgDf5TtjvMF14XwxA_8DvIOjglOm7-9-5VIfkBdz6BO-fqwTcvH50-zkS3n-7fTs5ON52UkpZAl03kpL0baoGiqU6jiVytbMoqat4ijnjVRao6xBtYIyaKBFoS1rdQUWxIR82Hqvx3aFtkM_ROjNdXQriGsTwJl_T7xbmkW4MU3NK940WXD4KIjh-4hpMCuXOux78BjGZLhmQtBKig367j_0Kowxf9iG4pRzxvOjJuT9lupiSCnifDcMo2YTl8lxmYe4Mvv27-l35J98MnC8BW5dj-unTWb29Wyr_A0YGaC1</recordid><startdate>202210</startdate><enddate>202210</enddate><creator>Mutayoba, Beatrice Kemilembe</creator><creator>Ershova, Julia</creator><creator>Lyamuya, Eligius</creator><creator>Hoelscher, Michael</creator><creator>Heinrich, Norbert</creator><creator>Kilale, Andrew Martin</creator><creator>Range, Nyagosya Segere</creator><creator>Ngowi, Benard James</creator><creator>Ntinginya, Nyanda Elias</creator><creator>Mfaume, Saidi Mwinjuma</creator><creator>Nkiligi, Emmanuel</creator><creator>Doulla, Basra</creator><creator>Lyimo, Johnson</creator><creator>Kisonga, Riziki</creator><creator>Kingalu, Amri</creator><creator>Lema, Yakobo</creator><creator>Kondo, Zuwena</creator><creator>Pletschette, Michel</creator><general>Blackwell Publishing Ltd</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202210</creationdate><title>The second national anti‐tuberculosis drug resistance survey in Tanzania, 2017–2018</title><author>Mutayoba, Beatrice Kemilembe ; Ershova, Julia ; Lyamuya, Eligius ; Hoelscher, Michael ; Heinrich, Norbert ; Kilale, Andrew Martin ; Range, Nyagosya Segere ; Ngowi, Benard James ; Ntinginya, Nyanda Elias ; Mfaume, Saidi Mwinjuma ; Nkiligi, Emmanuel ; Doulla, Basra ; Lyimo, Johnson ; Kisonga, Riziki ; Kingalu, Amri ; Lema, Yakobo ; Kondo, Zuwena ; Pletschette, Michel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4434-a0fb4d0edbe590355c2045d81de70b52e4f94577e48a5b301a9abe37d1b76ada3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antitubercular Agents - pharmacology</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>Confidence intervals</topic><topic>Cross-Sectional Studies</topic><topic>Drug resistance</topic><topic>Drugs</topic><topic>Ethambutol</topic><topic>Extensively Drug-Resistant Tuberculosis - diagnosis</topic><topic>Extensively Drug-Resistant Tuberculosis - drug therapy</topic><topic>Extensively Drug-Resistant Tuberculosis - microbiology</topic><topic>Humans</topic><topic>Isoniazid</topic><topic>Isoniazid - therapeutic use</topic><topic>MDR‐TB</topic><topic>Microbial Sensitivity Tests</topic><topic>Missing data</topic><topic>Multidrug resistance</topic><topic>Mycobacterium tuberculosis</topic><topic>Patients</topic><topic>Polls & surveys</topic><topic>Resistance factors</topic><topic>Rifampin</topic><topic>Rifampin - therapeutic use</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Sampling designs</topic><topic>Sputum</topic><topic>Statistical analysis</topic><topic>Streptomycin</topic><topic>Streptomycin - therapeutic use</topic><topic>survey</topic><topic>Surveys</topic><topic>Tanzania</topic><topic>Tanzania - epidemiology</topic><topic>Tuberculosis</topic><topic>Tuberculosis, Multidrug-Resistant - drug therapy</topic><topic>Tuberculosis, Multidrug-Resistant - epidemiology</topic><topic>Tuberculosis, Multidrug-Resistant - microbiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mutayoba, Beatrice Kemilembe</creatorcontrib><creatorcontrib>Ershova, Julia</creatorcontrib><creatorcontrib>Lyamuya, Eligius</creatorcontrib><creatorcontrib>Hoelscher, Michael</creatorcontrib><creatorcontrib>Heinrich, Norbert</creatorcontrib><creatorcontrib>Kilale, Andrew Martin</creatorcontrib><creatorcontrib>Range, Nyagosya Segere</creatorcontrib><creatorcontrib>Ngowi, Benard James</creatorcontrib><creatorcontrib>Ntinginya, Nyanda Elias</creatorcontrib><creatorcontrib>Mfaume, Saidi Mwinjuma</creatorcontrib><creatorcontrib>Nkiligi, Emmanuel</creatorcontrib><creatorcontrib>Doulla, Basra</creatorcontrib><creatorcontrib>Lyimo, Johnson</creatorcontrib><creatorcontrib>Kisonga, Riziki</creatorcontrib><creatorcontrib>Kingalu, Amri</creatorcontrib><creatorcontrib>Lema, Yakobo</creatorcontrib><creatorcontrib>Kondo, Zuwena</creatorcontrib><creatorcontrib>Pletschette, Michel</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Tropical medicine & international health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mutayoba, Beatrice Kemilembe</au><au>Ershova, Julia</au><au>Lyamuya, Eligius</au><au>Hoelscher, Michael</au><au>Heinrich, Norbert</au><au>Kilale, Andrew Martin</au><au>Range, Nyagosya Segere</au><au>Ngowi, Benard James</au><au>Ntinginya, Nyanda Elias</au><au>Mfaume, Saidi Mwinjuma</au><au>Nkiligi, Emmanuel</au><au>Doulla, Basra</au><au>Lyimo, Johnson</au><au>Kisonga, Riziki</au><au>Kingalu, Amri</au><au>Lema, Yakobo</au><au>Kondo, Zuwena</au><au>Pletschette, Michel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The second national anti‐tuberculosis drug resistance survey in Tanzania, 2017–2018</atitle><jtitle>Tropical medicine & international health</jtitle><addtitle>Trop Med Int Health</addtitle><date>2022-10</date><risdate>2022</risdate><volume>27</volume><issue>10</issue><spage>891</spage><epage>901</epage><pages>891-901</pages><issn>1360-2276</issn><eissn>1365-3156</eissn><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.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>36089572</pmid><doi>10.1111/tmi.13814</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Tropical medicine & international health, 2022-10, Vol.27 (10), p.891-901 |
| issn | 1360-2276 1365-3156 |
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| source | MEDLINE; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; Wiley Online Library (Open Access Collection) |
| subjects | Antitubercular Agents - pharmacology Antitubercular Agents - therapeutic use Confidence intervals Cross-Sectional Studies Drug resistance Drugs Ethambutol Extensively Drug-Resistant Tuberculosis - diagnosis Extensively Drug-Resistant Tuberculosis - drug therapy Extensively Drug-Resistant Tuberculosis - microbiology Humans Isoniazid Isoniazid - therapeutic use MDR‐TB Microbial Sensitivity Tests Missing data Multidrug resistance Mycobacterium tuberculosis Patients Polls & surveys Resistance factors Rifampin Rifampin - therapeutic use Risk analysis Risk factors Sampling designs Sputum Statistical analysis Streptomycin Streptomycin - therapeutic use survey Surveys Tanzania Tanzania - epidemiology Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Tuberculosis, Multidrug-Resistant - microbiology |
| title | The second national anti‐tuberculosis drug resistance survey in Tanzania, 2017–2018 |
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