Multi-Resistant Tuberculosis in Western Algeria: about 36 Cases

Guenaoui , K,Ouardi , A,Kanoun, K,Harir , N,Ouali , S

doi:10.21608/eajbsc.2021.178245

Abstract

Multi-drug resistant tuberculosis (MDR-TB) is defined by the loss of susceptibility of Mycobacterium tuberculosis complex strains to the two major anti-tuberculosis drugs: isoniazid (H) and Rifampicin (R). This resistance may be acquired or primary. The aim of our study was to describe the epidemiological, clinical, bacteriological and evolutionary profile of multi-resistant tuberculosis patients in Western Algeria. To do so, aretrospective analytical study, which included 36 patients, was carried out in the pneumo-phthisiology department (B) of the Oran University Hospital (West Algeria) from January 2010 to December 2014. Our result showed an average age of 33.7 years. The risk factors for MDR-TB highlighted were tobacco (n=12; 33.3%), alcoholism (n=1; 2.8%) and family history of MDR-TB (n=3; 8.33). Primary MDR-TB was present in 11.11% of cases and secondary MDR-TB in 88.89% of cases. There was resistance to H and R in 13.8% of cases (n=5); to H, R and Streptomycin (S) in 50% of cases (n=18); to H, R and Ethambutol (E) in 5.6% of cases (n=2). The percentage of patients who had lost the sensitivity of the Bacillus to the four first-line anti-tuberculosis drugs (H, R, S, and E) was 25% of all patients tested (n=9) and H, R, S, and Ofloxacin (O) in one case. Five patients died. The rate of primary resistance found in this study constitutes a threat to efforts to control MDR tuberculosis in Algeria. It is therefore important to update the results and assess the extent of the problem.

Highlights

The World Health Organization (WHO) estimates that 2 billion people are infected with Mycobacterium tuberculosis (TB), of whom 7-9 million become ill and 3 million die each year (Aka Danguy, 2007)
In 2012, the WHO estimates that 410 multi-drug resistant tuberculosis worldwide and that one-third of them died from it (Baough et al, 2007)
Multi-drug resistant tuberculosis (MDR-TB) exists in all regions of the world but is common in countries with a high incidence of tuberculosis and human immunodeficiency virus (HIV) coinfection, where, the management of patients is uncertain (Caminero, 2006; Dominique, 2007)

Summary

Introduction

The World Health Organization (WHO) estimates that 2 billion people are infected with Mycobacterium tuberculosis (TB), of whom 7-9 million become ill and 3 million die each year (Aka Danguy, 2007). The dual resistance to rifampicin and isoniazid, the two major anti-TB drugs, known as multi-drug resistance (MDR), is worrying because of the difficulty of treating patients, its high mortality rate, and its potential impact on the epidemiology of the disease (Baough et al.,2007). MDR-TB exists in all regions of the world but is common in countries with a high incidence of tuberculosis and HIV coinfection, where, the management of patients is uncertain (Caminero, 2006; Dominique, 2007). The prevalence of bacterial resistance to anti-tuberculosis drugs among previously untreated patients (or primary resistance) is the epidemiological index that reflects the quality of chemotherapy applied in a national program (Holmes et al, 1998). In view of the need for reliable data on tuberculosis drug resistance and more on multidrug-resistant cases, the aim of this study was to describe the epidemiological, clinical, bacteriological and even evolutionary profile of multidrug-resistant tuberculosis patients in western Algeria

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Methods

Results

Conclusion