Resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of national surveillance data in Gabon, Central Africa

OBJECTIVE: Routinely generated surveillance data are important for monitoring the effectiveness of MDR-TB control strategies. Incidence of rifampicin-resistant tuberculosis (RR-TB) is a key indicator for monitoring MDR-TB. METHODS: In a longitudinal nationwide retrospective study, 8 years (2014–2021...

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Detalles Bibliográficos
Autores principales: Abdul, Jabar Babatunde Pacome Achimi Agbo, Adegbite, Bayode Romeo, Ndanga, Micheska Epola Dibamba, Edoa, Jean Ronald, Mevyann, Rhett Chester, Mfoumbi, Guy Rogue Arnault Ibinda, de Dieu, Tshisekedi Jean, Mahoumbou, Jocelyn, Biyogho, Christopher Mebiame, Jeyaraj, Sankarganesh, Niemann, Stefan, Lell, Bertrand, Kremsner, Peter Gottfried, Alabi, Abraham Sunday, Adegnika, Ayola Akim, Grobusch, Martin Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Original Paper
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616411/
https://www.ncbi.nlm.nih.gov/pubmed/36307576
http://dx.doi.org/10.1007/s15010-022-01941-5
Descripción
Sumario:OBJECTIVE: Routinely generated surveillance data are important for monitoring the effectiveness of MDR-TB control strategies. Incidence of rifampicin-resistant tuberculosis (RR-TB) is a key indicator for monitoring MDR-TB. METHODS: In a longitudinal nationwide retrospective study, 8 years (2014–2021) of sputum samples from presumptively drug-resistant tuberculosis patients from all regions of Gabon were referred to the national tuberculosis reference laboratory. Samples were analysed using GeneXpert MTB/RIF and Genotype MTBDRsl version 2/Line Probe Assay. RESULTS: Of 3057 sputum samples from presumptive tuberculosis patients, both from local hospital and from referral patients, 334 were RR-TB. The median patient age was 33 years (interquartile range 26–43); one third was newly diagnosed drug-resistant tuberculosis patients; one-third was HIV-positive. The proportion of men with RR-TB was significantly higher than that of women (55% vs 45%; p < 0.0001). Patients aged 25–35 years were most affected (32%; 108/334). The cumulative incidence of RR-TB was 17 (95% CI 15–19)/100,000 population over 8 years. The highest incidences were observed in 2020 and 2021. A total of 281 samples were analysed for second-line drug resistance. The proportions of study participants with MDR-TB, pre-XDR-TB and XDR-TB were 90.7% (255/281), 9% (25/281) and 0.3% (1/281), respectively. The most-common mutations in fluoroquinolones resistance isolates was gyrA double mutation gyrA MUT3B and MUT3C (23%; 4/17). Most (64%; 6/8) second-line injectable drugs resistance isolates were characterised by missing both rrs WT2 and MUT2 banding. CONCLUSION: The increasing incidence of MDR-TB infection in Gabon is alarming. It is highest in the 25–35 years age category. The incidence of MDR-TB infection in treatment-naïve patients calls for case finding and contact tracing strategy improvement. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s15010-022-01941-5.

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