Abstract
BackgroundEmergence of Multidrug-resistant (MDR) strains constitutes a significant public health problem worldwide. Prevalence of MDR tuberculosis from Chad is unavailable to date.MethodsWe collected samples from consecutive TB patients nationwide in the seven major cities of Chad between 2007 and 2012 to characterize drug resistance and the population structure of circulating Mycobacterium tuberculosis complex (MTBC) strains. We tested drug sensitivity using Line Probe Assays and phenotypic drug susceptibility testing (DST) were used for second line drugs. We genotyped the isolates using spoligotype analysis and MIRU-VNTR.ResultsA total of 311 cultures were isolated from 593 patients. The MDR prevalence was 0.9% among new patients and 3.5% among retreatment patients, and no second line drug resistance was identified. The distribution of genotypes suggests a dissemination of MDR strains in the Southern city of Moundou, bordering Cameroon and Central African Republic.ConclusionEmerging MDR isolates pose a public health threat to Southern Chad, with risk to neighboring countries. This study informs public health practitioners, justifying the implementation of continuous surveillance with DST for all retreatment cases as well as contacts of MDR patients, in parallel with provision of adequate 2nd line regimens in the region.
Highlights
Emergence of Multidrug-resistant (MDR) strains constitutes a significant public health problem worldwide
This study demonstrates the emergence and clonal transmission of MDR-TB strains, originating from one of two major transmission clusters of TB strains in the Southern city of Moundou, close to the Cameroonian and Central African Republic’s border
Study population and M. tuberculosis strains isolated Of the 593 samples collected, a total of 326 samples were positive after culture, and 311 were available for analysis
Summary
Emergence of Multidrug-resistant (MDR) strains constitutes a significant public health problem worldwide. Tuberculosis (TB), caused by species of the Mycobacterium tuberculosis complex (MTBc), remains a major public health problem worldwide. In 2014, 12,305 TB cases were reported in Chad, of whom 22% died, accounting for a major. The emergence of strains resistant to multiple antibiotics has compromised global TB management. In Chad, as no such data on drug-resistant TB was available, we collected samples from seven major cities between 2007 and 2012 to measure drug-susceptibility to first and second line drugs, and to study the population structure of circulating strains. This study demonstrates the emergence and clonal transmission of MDR-TB strains, originating from one of two major transmission clusters of TB strains in the Southern city of Moundou, close to the Cameroonian and Central African Republic’s border
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