S Ade1, A Trébucq2, A D Harries3, D Affolabi4, G Ade4, G Agodokpessi4, P Wachinou4, S Anagonou4, M Gninafon4. 1. National Tuberculosis Programme, Cotonou, Benin ; International Union Against Tuberculosis and Lung Disease, Paris, France. 2. International Union Against Tuberculosis and Lung Disease, Paris, France. 3. International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK. 4. National Tuberculosis Programme, Cotonou, Benin.
Abstract
SETTING: Centre National Hospitalier de Pneumo-Phtisi-ologie, Cotonou, Benin. OBJECTIVE: To determine the proportion of individuals needing treatment for multidrug-resistant tuberculosis (MDR-TB) among patients previously treated for TB. DESIGN: A retrospective cross-sectional study of all patients previously treated for TB in Cotonou from 2003 to 2011. RESULTS: Of 956 patients on retreatment, 897 (94%) underwent culture and/or a line-probe assay. For different reasons, 594 (66%) underwent drug susceptibility testing for rifampicin (RMP), of whom 95 (16%) had RMP resistance (68 multidrug-resistance [MDR] and 27 other RMP resistance) and therefore needed treatment for MDR-TB. These represent 39% of patients who failed/relapsed after standardised retreatment, and 20% of those who failed, 19% of defaulters and 11% of relapses after first-line treatment. Residence outside of Benin was associated with a higher risk of RMP resistance (RR 3.13, 95%CI 2.19-4.48, P < 0.01). From 2003 to 2011, the prevalence of RMP resistance decreased from 25% to 5% among patients living in Benin. Human immunodeficiency virus (HIV) prevalence was 25%; no association was found between HIV and RMP resistance. Of patients failing treatment, 48% were fully susceptible, 22% were monoresistant and 8% polyresistant. CONCLUSION: The majority of patients who fail retreatment or first-line treatment in Cotonou do not require empirical treatment for MDR-TB.
SETTING: Centre National Hospitalier de Pneumo-Phtisi-ologie, Cotonou, Benin. OBJECTIVE: To determine the proportion of individuals needing treatment for multidrug-resistant tuberculosis (MDR-TB) among patients previously treated for TB. DESIGN: A retrospective cross-sectional study of all patients previously treated for TB in Cotonou from 2003 to 2011. RESULTS: Of 956 patients on retreatment, 897 (94%) underwent culture and/or a line-probe assay. For different reasons, 594 (66%) underwent drug susceptibility testing for rifampicin (RMP), of whom 95 (16%) had RMP resistance (68 multidrug-resistance [MDR] and 27 other RMP resistance) and therefore needed treatment for MDR-TB. These represent 39% of patients who failed/relapsed after standardised retreatment, and 20% of those who failed, 19% of defaulters and 11% of relapses after first-line treatment. Residence outside of Benin was associated with a higher risk of RMP resistance (RR 3.13, 95%CI 2.19-4.48, P < 0.01). From 2003 to 2011, the prevalence of RMP resistance decreased from 25% to 5% among patients living in Benin. Human immunodeficiency virus (HIV) prevalence was 25%; no association was found between HIV and RMP resistance. Of patients failing treatment, 48% were fully susceptible, 22% were monoresistant and 8% polyresistant. CONCLUSION: The majority of patients who fail retreatment or first-line treatment in Cotonou do not require empirical treatment for MDR-TB.
Authors: A D Harries; T E Nyirenda; J R Kemp; B S Squire; P Godfrey-Faussett; F M L Salaniponi Journal: Int J Tuberc Lung Dis Date: 2003-11 Impact factor: 2.373
Authors: A Trébucq; D A Enarson; C Y Chiang; A Van Deun; A D Harries; F Boillot; A Detjen; P I Fujiwara; S M Graham; I Monedero; I D Rusen; H L Rieder Journal: Int J Tuberc Lung Dis Date: 2011-10-13 Impact factor: 2.373
Authors: M Marjani; P Baghaei; P Tabarsi; M Shamaei; D Mansouri; M R Masjedi; A Velayati Journal: East Mediterr Health J Date: 2012-09 Impact factor: 1.628
Authors: M Gninafon; L Tawo; F Kassa; G P Monteiro; J P Zellweger; H Shang; K Lambregts; A Trébucq Journal: Int J Tuberc Lung Dis Date: 2004-10 Impact factor: 2.373
Authors: M C Becerra; J Freeman; J Bayona; S S Shin; J Y Kim; J J Furin; B Werner; A Sloutsky; R Timperi; M E Wilson; M Pagano; P E Farmer Journal: Int J Tuberc Lung Dis Date: 2000-02 Impact factor: 2.373
Authors: Catharina C Boehme; Mark P Nicol; Pamela Nabeta; Joy S Michael; Eduardo Gotuzzo; Rasim Tahirli; Ma Tarcela Gler; Robert Blakemore; William Worodria; Christen Gray; Laurence Huang; Tatiana Caceres; Rafail Mehdiyev; Lawrence Raymond; Andrew Whitelaw; Kalaiselvan Sagadevan; Heather Alexander; Heidi Albert; Frank Cobelens; Helen Cox; David Alland; Mark D Perkins Journal: Lancet Date: 2011-04-18 Impact factor: 79.321