A perspective of Mycobacterium Tuberculosis resistance on patients with retreat in Madagascar

Abstract

Introduction: Despite advances in diagnostic and therapeutic way, drug-resistanttuberculosis is an increasingly worrying threat. Several studies suggest that one ofthe risk factors for carrying resistant Mycobacterium tuberculosis is the historyof anti-tuberculosis treatment. The objective of our study is to describe theResistance Profile of Mycobacterium Tuberculosis of patients in retreatment inMadagascar. Methods: This is a descriptive and retrospective study, carried outfrom January 2014 to September 2018 (45 months). All the cases of re-treatementrecorded in the database of the National Tuberculosis Control Program inMadagascar were included in the study.Results: We gathered 1456 cases, the average age was 40 years, there was a malepredominance(sex ratio of 2.32). In the 1302 cases where the category wasspecified, there was a predominance of relapse (76.57%). According to theculture, the incidence of rifampicin resistance was 05.36% (78/1456) including83.33% of cases of multi-resistant tuberculosis (MDR-TB) (65/78). The incidenceof isoniazid monoresistance was 05.49% (80/1456). Carrying MDR-TB is much moreimportant for patients who have failed (69.43%). The GeneXpert mtb/RIF enabledus to detect more cases of Rifampicine monoresistance (97 cases).Conclusion: cases of retreatment is a real source of the emergence of MDR-TB inMadagascar, especially cases of failure and relapse. Which is consistent with the data inthe literature. The treatment effectiveness of new cases must be maximum to preventthese cases of retreatment.Key words: drug resistance–Madagascar–profil–tuberculosis