Pre-extensively drug-resistant tuberculosis among multidrug-resistant tuberculosis patients in Ethiopia: a laboratory-based surveillance study

被引：12

作者：

Diriba, Getu ^{[1
,4
]}

Alemu, Ayinalem ^{[1
]}

Tola, Habteyes Hailu ^{[2
]}

Yenew, Bazezew ^{[1
]}

Amare, Misikir ^{[1
]}

Eshetu, Kirubel ^{[3
]}

Sinshaw, Waganeh ^{[1
]}

Abebaw, Yeshiwork ^{[1
]}

Meaza, Abyot ^{[1
]}

Seid, Getachew ^{[1
]}

Moga, Shewki ^{[1
]}

Zerihun, Betselot ^{[1
]}

Getu, Melak ^{[1
]}

Dagne, Biniyam ^{[1
]}

Mollalign, Hilina ^{[1
]}

Tadesse, Mengistu

Buta, Bedo ^{[1
]}

Wordofa, Niguse ^{[1
]}

Alemu, Ephrem ^{[1
]}

Erresso, Ashenafi ^{[1
]}

Hailu, Michael ^{[1
]}

Tefera, Zigba ^{[1
]}

Wondimu, Amanuel ^{[1
]}

Belhu, Tegegn ^{[1
]}

Gamtesa, Dinka Fekadu ^{[1
]}

Getahun, Muluwork ^{[1
]}

Kebede, Abebaw

Abdela, Saro ^{[1
]}

机构：

[1] Ethiopian Publ Hlth Inst, Addis Ababa, Ethiopia

[2] Selale Univ, Coll Hlth Sci, Dept Publ Hlth, Fiche, Ethiopia

[3] USAID Eliminate TB Project, Management Sci Hlth, Addis Ababa, Ethiopia

[4] Ethiopian Publ Hlth Inst, POB 1242, Addis Ababa, Ethiopia

来源：

IJID REGIONS | 2022年 / 5卷

关键词：

drug-resistant tuberculosis; multidrug-resistant tuberculosis; pre-extensively drug-resistant; MYCOBACTERIUM-TUBERCULOSIS; PROVINCE; MTBDRSL; XDR; TB;

D O I：

10.1016/j.ijregi.2022.08.012

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: The rise of drug-resistant tuberculosis (DR-TB) has presented a substantial challenge to the national tuberculosis (TB) control program. Understanding the epidemiology of pre-extensively drug-resistant tuberculosis (pre-XDR-TB) could help clinicians to adapt MDR-TB treatment regimens at an earlier stage. This study aimed to assess second-line anti-TB drug resistance among MDR-TB patients in Ethiopia using routine laboratory-based data. Methods: Laboratory-based cross-sectional data were collected from the national TB reference laboratory and seven regional tuberculosis culture laboratories in Ethiopia from July 2019 to March 2022. The required data, such as drug-susceptibility testing (DST) results and sociodemographics, were collected on a structured checklist from laboratory registration books and electronic databases. Data were entered into a Microsoft Excel spreadsheet and analyzed using SPSS version 23. Descriptive statistics were performed to show the distribution and magnitude of drug resistance. Results: Second-line drugs (SLDs) susceptibility testing was performed for 644 MDR isolates, of which 19 (3%) were found to be pre-XDR-TB cases. Of the total MDR-TB isolates, 19 (3%) were resistant to at least one fluoro-quinolone drug, while 11 (1.7%) were resistant to at least one injectable second-line drug. Of the 644 MDR-TB isolates, 1.9% (5/261) pre-XDR were from new MDR-TB cases, while 3.7% (14/383) were from previously treated MDR-TB patients. The most frequently identified mutations, based on MTBDRsl results, were in codon A90V of the gyrA gene (77.3%) and A1401G of the rrs gene (45.5%). Conclusion: The overall prevalence of pre-XDR-TB in Ethiopia is considerable. The majority of SLD resistance mutations were in the gyrA gene at position A90V. Modern, rapid DST is necessary to enable identification of pre-XDR-TB and XDR-TB in supporting proper regimen administration for patients.

引用

页码：39 / 43

页数：5

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