M L Aznar1, A Rando-Segura2, M M Moreno3, M E Soley4, E S Igual4, C Bocanegra1, E G Olivas3, A Ninda Eugénio3, A Zacarias3, D Katimba3, E Gabriel3, J Mendioroz5, M T López García3, T P Suñe4, M T Tórtola Fernández4, I Molina Romero6. 1. Infectious Disease Department, Vall d'Hebron University Hospital, Programa de Salut Internacional de l'Institut Català de la Salut Barcelona, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain, Hospital Nossa Senhora da Paz, Cubal, Angola. 2. Infectious Disease Department, Vall d'Hebron University Hospital, Programa de Salut Internacional de l'Institut Català de la Salut Barcelona, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain, Hospital Nossa Senhora da Paz, Cubal, Angola, Microbiology Department, Vall d'Hebron University Hospital, Programme de Salut Internacional de l'Institut Català de la Salut Barcelona, Universitat Autònoma de Barcelona, Barcelona. 3. Hospital Nossa Senhora da Paz, Cubal, Angola. 4. Microbiology Department, Vall d'Hebron University Hospital, Programme de Salut Internacional de l'Institut Català de la Salut Barcelona, Universitat Autònoma de Barcelona, Barcelona. 5. Support Research Unit, Territorial Health Management of Central Catalonia, Barcelona, Spain. 6. Infectious Disease Department, Vall d'Hebron University Hospital, Programa de Salut Internacional de l'Institut Català de la Salut Barcelona, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Abstract
BACKGROUND: Although the Republic of Angola is one of the 14 countries figuring in the three high tuberculosis (TB) burden country lists, the true multidrug-resistant TB (MDR-TB) situation is unknown. MATERIAL AND METHODS: Patients aged 16 years with a diagnosis of pulmonary TB were prospectively enrolled from June 2014 to July 2015. Sputum samples were collected for culture and drug susceptibility testing in all patients, and for Xpert® MTB/RIF testing in all previously treated patients and in new patients whose sputum remained smear-positive after 2 months of treatment. RESULTS: A total of 422 patients were included; Mycobacterium tuberculosis was isolated in 308 sputum samples. The prevalence of MDR-TB was 8.0% (18/225) in new patients and 71.1% (59/83) in previously treated patients. Male sex (OR 2.95, 95%CI 1.35-6.44, P = 0.007), previous anti-tuberculosis treatment (OR 20.86, 95%CI 9.53-45.67, P < 0.001), presence of pleural thickening (OR 7.68, 95%CI 1.57-37.43, P = 0.012) and duration of illness >4 months (OR 3.34, 95%CI 1.45-7.69, P = 0.005) were independent risk factors for MDR-TB. CONCLUSIONS: The prevalence of MDR-TB in Cubal, Angola, was higher than estimated by the World Health Organization for Angola and one of the highest worldwide. Facilities to diagnose and treat MDR-TB are urgently needed in Angola.
BACKGROUND: Although the Republic of Angola is one of the 14 countries figuring in the three high tuberculosis (TB) burden country lists, the true multidrug-resistant TB (MDR-TB) situation is unknown. MATERIAL AND METHODS:Patients aged 16 years with a diagnosis of pulmonary TB were prospectively enrolled from June 2014 to July 2015. Sputum samples were collected for culture and drug susceptibility testing in all patients, and for Xpert® MTB/RIF testing in all previously treated patients and in new patients whose sputum remained smear-positive after 2 months of treatment. RESULTS: A total of 422 patients were included; Mycobacterium tuberculosis was isolated in 308 sputum samples. The prevalence of MDR-TB was 8.0% (18/225) in new patients and 71.1% (59/83) in previously treated patients. Male sex (OR 2.95, 95%CI 1.35-6.44, P = 0.007), previous anti-tuberculosis treatment (OR 20.86, 95%CI 9.53-45.67, P < 0.001), presence of pleural thickening (OR 7.68, 95%CI 1.57-37.43, P = 0.012) and duration of illness >4 months (OR 3.34, 95%CI 1.45-7.69, P = 0.005) were independent risk factors for MDR-TB. CONCLUSIONS: The prevalence of MDR-TB in Cubal, Angola, was higher than estimated by the World Health Organization for Angola and one of the highest worldwide. Facilities to diagnose and treat MDR-TB are urgently needed in Angola.
Authors: María Luisa Aznar; Ariadna Rando Segura; María Milagros Moreno; Mateu Espasa; Elena Sulleiro; Cristina Bocanegra; Eva Gil Olivas; Arlete Nindia Eugénio; Adriano Zacarias; Domingos Katimba; Estevao Gabriel; Jacobo Mendioroz; Maria Teresa López García; Tomas Pumarola; María Teresa Tórtola; Israel Molina Journal: Am J Trop Med Hyg Date: 2019-09 Impact factor: 2.345
Authors: Rafaela M Ribeiro; Luzia Gonçalves; Philip J Havik; Isabel Craveiro Journal: Int J Environ Res Public Health Date: 2022-03-23 Impact factor: 3.390