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

Resistance to Tuberculosis drugs has become a major threat to the control of tuberculosis (TB) globally. We conducted the first nation-wide drug resistance survey to investigate the level and pattern of resistance to first-line TB drugs among newly and previously treated sputum smear-positive TB cas...

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Autores principales: Sylverken, Augustina Angelina, Kwarteng, Alexander, Twumasi-Ankrah, Sampson, Owusu, Michael, Arthur, Rejoice Agyeiwaa, Dumevi, Rexford Mawunyo, Adu-Amoah, Louis, Addofoh, Nicholas, Okyere, Portia Boakye, Dzata, Francisca, Bonsu, Frank, Adusi-Poku, Yaw, Kranzer, Katharina, Siroka, Andrew, van Gemert, Wayne, Dean, Anna, Owusu-Dabo, Ellis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191906/
https://www.ncbi.nlm.nih.gov/pubmed/34111159
http://dx.doi.org/10.1371/journal.pone.0252819
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author Sylverken, Augustina Angelina
Kwarteng, Alexander
Twumasi-Ankrah, Sampson
Owusu, Michael
Arthur, Rejoice Agyeiwaa
Dumevi, Rexford Mawunyo
Adu-Amoah, Louis
Addofoh, Nicholas
Okyere, Portia Boakye
Dzata, Francisca
Bonsu, Frank
Adusi-Poku, Yaw
Kranzer, Katharina
Siroka, Andrew
van Gemert, Wayne
Dean, Anna
Owusu-Dabo, Ellis
author_facet Sylverken, Augustina Angelina
Kwarteng, Alexander
Twumasi-Ankrah, Sampson
Owusu, Michael
Arthur, Rejoice Agyeiwaa
Dumevi, Rexford Mawunyo
Adu-Amoah, Louis
Addofoh, Nicholas
Okyere, Portia Boakye
Dzata, Francisca
Bonsu, Frank
Adusi-Poku, Yaw
Kranzer, Katharina
Siroka, Andrew
van Gemert, Wayne
Dean, Anna
Owusu-Dabo, Ellis
author_sort Sylverken, Augustina Angelina
collection PubMed
description Resistance to Tuberculosis drugs has become a major threat to the control of tuberculosis (TB) globally. We conducted the first nation-wide drug resistance survey to investigate the level and pattern of resistance to first-line TB drugs among newly and previously treated sputum smear-positive TB cases. We also evaluated associations between potential risk factors and TB drug resistance. Using the World Health Organization (WHO) guidelines on conducting national TB surveys, we selected study participants from 33 health facilities from across the country, grouped into 29 clusters, and included them into the survey. Between April 2016 and June 2017, a total of 927 patients (859 new and 68 previously treated) were enrolled in the survey. Mycobacterium tuberculosis complex (MTBC) isolates were successfully cultured from 598 (65.5%) patient samples and underwent DST, 550 from newly diagnosed and 48 from previously treated patients. The proportion of patients who showed resistance to any of the TB drugs tested was 25.2% (95% CI; 21.8–28.9). The most frequent resistance was to Streptomycin (STR) (12.3%), followed by Isoniazid (INH) (10.4%), with Rifampicin (RIF), showing the least resistance of 2.4%. Resistance to Isoniazid and Rifampicin (multi-drug resistance) was found in 19 (3.2%; 95% CI: 1.9–4.9) isolates. Prevalence of multidrug resistance was 7 (1.3%; 95% CI: 0.5–2.6) among newly diagnosed and 12 (25.0%; 95% CI: 13.6–39.6) among previously treated patients. At both univariate and multivariate analysis, MDR-TB was positively associated with previous history of TB treatment (OR = 5.09, 95% CI: 1.75–14.75, p = 0.003); (OR = 5.41, 95% CI: 1.69–17.30, p = 0.004). The higher levels of MDR-TB and overall resistance to any TB drug among previously treated patients raises concerns about adherence to treatment. This calls for strengthening existing TB programme measures to ensure a system for adequately testing and monitoring TB drug resistance.
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spelling pubmed-81919062021-06-10 The burden of drug resistance tuberculosis in Ghana; results of the First National Survey Sylverken, Augustina Angelina Kwarteng, Alexander Twumasi-Ankrah, Sampson Owusu, Michael Arthur, Rejoice Agyeiwaa Dumevi, Rexford Mawunyo Adu-Amoah, Louis Addofoh, Nicholas Okyere, Portia Boakye Dzata, Francisca Bonsu, Frank Adusi-Poku, Yaw Kranzer, Katharina Siroka, Andrew van Gemert, Wayne Dean, Anna Owusu-Dabo, Ellis PLoS One Research Article Resistance to Tuberculosis drugs has become a major threat to the control of tuberculosis (TB) globally. We conducted the first nation-wide drug resistance survey to investigate the level and pattern of resistance to first-line TB drugs among newly and previously treated sputum smear-positive TB cases. We also evaluated associations between potential risk factors and TB drug resistance. Using the World Health Organization (WHO) guidelines on conducting national TB surveys, we selected study participants from 33 health facilities from across the country, grouped into 29 clusters, and included them into the survey. Between April 2016 and June 2017, a total of 927 patients (859 new and 68 previously treated) were enrolled in the survey. Mycobacterium tuberculosis complex (MTBC) isolates were successfully cultured from 598 (65.5%) patient samples and underwent DST, 550 from newly diagnosed and 48 from previously treated patients. The proportion of patients who showed resistance to any of the TB drugs tested was 25.2% (95% CI; 21.8–28.9). The most frequent resistance was to Streptomycin (STR) (12.3%), followed by Isoniazid (INH) (10.4%), with Rifampicin (RIF), showing the least resistance of 2.4%. Resistance to Isoniazid and Rifampicin (multi-drug resistance) was found in 19 (3.2%; 95% CI: 1.9–4.9) isolates. Prevalence of multidrug resistance was 7 (1.3%; 95% CI: 0.5–2.6) among newly diagnosed and 12 (25.0%; 95% CI: 13.6–39.6) among previously treated patients. At both univariate and multivariate analysis, MDR-TB was positively associated with previous history of TB treatment (OR = 5.09, 95% CI: 1.75–14.75, p = 0.003); (OR = 5.41, 95% CI: 1.69–17.30, p = 0.004). The higher levels of MDR-TB and overall resistance to any TB drug among previously treated patients raises concerns about adherence to treatment. This calls for strengthening existing TB programme measures to ensure a system for adequately testing and monitoring TB drug resistance. Public Library of Science 2021-06-10 /pmc/articles/PMC8191906/ /pubmed/34111159 http://dx.doi.org/10.1371/journal.pone.0252819 Text en © 2021 Sylverken et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Sylverken, Augustina Angelina
Kwarteng, Alexander
Twumasi-Ankrah, Sampson
Owusu, Michael
Arthur, Rejoice Agyeiwaa
Dumevi, Rexford Mawunyo
Adu-Amoah, Louis
Addofoh, Nicholas
Okyere, Portia Boakye
Dzata, Francisca
Bonsu, Frank
Adusi-Poku, Yaw
Kranzer, Katharina
Siroka, Andrew
van Gemert, Wayne
Dean, Anna
Owusu-Dabo, Ellis
The burden of drug resistance tuberculosis in Ghana; results of the First National Survey
title The burden of drug resistance tuberculosis in Ghana; results of the First National Survey
title_full The burden of drug resistance tuberculosis in Ghana; results of the First National Survey
title_fullStr The burden of drug resistance tuberculosis in Ghana; results of the First National Survey
title_full_unstemmed The burden of drug resistance tuberculosis in Ghana; results of the First National Survey
title_short The burden of drug resistance tuberculosis in Ghana; results of the First National Survey
title_sort burden of drug resistance tuberculosis in ghana; results of the first national survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191906/
https://www.ncbi.nlm.nih.gov/pubmed/34111159
http://dx.doi.org/10.1371/journal.pone.0252819
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