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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...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
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 |
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author | 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 |
author_facet | 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 |
author_sort | Abdul, Jabar Babatunde Pacome Achimi Agbo |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9616411 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-96164112022-10-31 Resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of national surveillance data in Gabon, Central Africa 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 Infection Original Paper 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. Springer Berlin Heidelberg 2022-10-28 2023 /pmc/articles/PMC9616411/ /pubmed/36307576 http://dx.doi.org/10.1007/s15010-022-01941-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Paper 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 Resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of national surveillance data in Gabon, Central Africa |
title | Resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of national surveillance data in Gabon, Central Africa |
title_full | Resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of national surveillance data in Gabon, Central Africa |
title_fullStr | Resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of national surveillance data in Gabon, Central Africa |
title_full_unstemmed | Resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of national surveillance data in Gabon, Central Africa |
title_short | Resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of national surveillance data in Gabon, Central Africa |
title_sort | resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of national surveillance data in gabon, central africa |
topic | Original Paper |
url | 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 |
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