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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Anti-Tuberculosis Drug Resistance among New and Previously Treated Sputum Smear-Positive Tuberculosis Patients in Uganda: Results of the First National Survey
PLoS ONE, Volume 8, No. 8, Article e70763, Year 2013
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Description
Background:Multidrug resistant and extensively drug resistant tuberculosis (TB) have become major threats to control of tuberculosis globally. The rates of anti-TB drug resistance in Uganda are not known. We conducted a national drug resistance survey to investigate the levels and patterns of resistance to first and second line anti-TB drugs among new and previously treated sputum smear-positive TB cases.Methods:Sputum samples were collected from a nationally representative sample of new and previously treated sputum smear-positive TB patients registered at TB diagnostic centers during December 2009 to February 2011 using a weighted cluster sampling method. Culture and drug susceptibility testing was performed at the national TB reference laboratory.Results:A total of 1537 patients (1397 new and 140 previously treated) were enrolled in the survey from 44 health facilities. HIV test result and complete drug susceptibility testing (DST) results were available for 1524 (96.8%) and 1325 (85.9%) patients, respectively. Of the 1209 isolates from new cases, resistance to any anti-TB drug was 10.3%, 5% were resistant to isoniazid, 1.9% to rifampicin, and 1.4% were multi drug resistant. Among the 116 isolates from previously treated cases, the prevalence of resistance was 25.9%, 23.3%, 12.1% and 12.1% respectively. Of the 1524 patients who had HIV testing 469 (30.7%) tested positive. There was no association between anti-TB drug resistance (including MDR) and HIV infection.Conclusion:The prevalence of anti-TB drug resistance among new patients in Uganda is low relative to WHO estimates. The higher levels of MDR-TB (12.1%) and resistance to any drug (25.3%) among previously treated patients raises concerns about the quality of directly observed therapy (DOT) and adherence to treatment. This calls for strengthening existing TB control measures, especially DOT, routine DST among the previously treated TB patients or periodic drug resistance surveys, to prevent and monitor development and transmission of drug resistant TB. © 2013 Lukoye et al.
Authors & Co-Authors
Lukoye, Deus
Uganda, Kampala
Uganda Ministry of Health
Adatu, Francis E.
Uganda, Kampala
Uganda Ministry of Health
Musisi, Kenneth
Uganda, Kampala
National Tuberculosis Reference Laboratory
Kasule, George William
Uganda, Kampala
National Tuberculosis Reference Laboratory
Were, Willy A.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Odeke, Rosemary M.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Kalamya, Julius Namonyo
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Awor, Anna Colletar
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Date, Anand A.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Joloba, Moses Lutaakome
Uganda, Kampala
Makerere University College of Health Sciences
Uganda, Kampala
National Tuberculosis Reference Laboratory
Statistics
Citations: 77
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0070763
e-ISSN:
19326203
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Uganda