Prevalence Of Multidrug-resistant Tuberculosis Research Articles

Prevalence of Multi-Drug Resistant Tuberculosis among Tuberculosis Patients Attending Chest Clinics in Osun-State, Nigeria.

The development of multidrug-resistant tuberculosis (MDR-TB) poses a considerable threat to tuberculosis control programmes in Nigeria. There is an increase in the prevalence of MDR-TB worldwide both among new tuberculosis cases as well as previously-treated ones. There is also a rise in transmission of resistant strains due to an increase in MDR-TB patients largely due to the poor drug compliance and the impact of Human immunodeficiency virus infection. Therefore, we intend to determine the extent of MDR-TB among attendees of chest clinics in Osun-State, Nigeria. The objective of this study was to determine the prevalence of MDR-TB among confirmed tuberculosis patients attending chest clinics in Osun-State, Nigeria. This study was conducted among 207 attendees of chest clinics in Osun-State between June, 2015 and October 15, 2016. Sputum and blood samples of the participants were collected. GeneXpert test was carried out first on the samples for simultaneous identification of MTB and rifampicin resistance. Sputum samples were cultured on Lowenstein-Jensen (L-J) medium using N-acetyl-Lcysteine- sodium hydroxide (NALC-NaOH) decontamination method. Drug susceptibility testing (DST) to three first-line drugs was carried out using the proportion DST method. The prevalence of MTB was found to be 27.5% while the prevalence of MDR-TB from the fifty-seven isolates was 10.5%. Previously treated and new cases had a prevalence of 7.0% and 3.5% MDR-TB, respectively. Seventy (33.8%) participants were positive for HIV infection, out of which twenty-six (12.6%) had co-infection of tuberculosis and HIV. The mono-resistance rates of the three first-line drugs used were: 5.3% and 8.7% for ethambutol (EMB) and isoniazid (INH), respectively. No isolate had mono-resistance (0%) to rifampicin (RIF). This study observed the prevalence of 27.5% MTB and a prevalence of 10.5% MDR-TB among the MTB isolates. The prevalence of TB is high in Osun State. MDR-TB prevalence is higher compared with the national estimate of MDR-TB (5.1%) of 2017. Resistant TB is a threat to national tuberculosis control and it is recommended that all the facilities be equipped to cater to its diagnosis.

Molecular detection of multidrug resistance pattern and associated gene mutations in M. tuberculosis isolates from newly diagnosed pulmonary tuberculosis patients in Addis Ababa, Ethiopia.

Multi-drug resistance is a major challenge in the control of tuberculosis. Despite newer modalities for diagnosis and treatment, people are still suffering from this disease. Understanding the common gene mutations conferring rifampicin and isoniazid resistance is crucial for the implementation of effective molecular tools at local and national levels. Hence, this study aimed to evaluate the molecular detection of rifampicin and isoniazid-resistant gene mutations in M.tuberculosis isolates in Addis Ababa, Ethiopia. Health Center-based cross-sectional study was conducted between January and September 2017 in Addis Ababa, Ethiopia. The collected sputum samples were processed for mycobacterial isolation and Region of difference 9 based polymerase chain reaction for species identification. To characterize the rifampicin and isoniazid-resistant M. tuberculosis isolates, a molecular genetic assay (GenoType MTBDRplus) was used; the assay is based on DNA-STRIP technology. Culture positivity was confirmed in 82.6% (190/230) of smear-positive newly diagnosed pulmonary tuberculosis cases enrolled in the study. From 190 isolates 93.2% were sensitive for both rifampicin and isoniazid, and 6.8% of the isolates were resistant to at least one of the tested anti-TB drugs. Gene mutations were observed in all studied multidrug resistance-associated gene loci (rpoB, katG, and inhA). Two isolates exhibited heteroresistance, a mutated, as well as wild type sequences, were detected in the respective strains. MDR-TB case was observed in 1.1% (2/190) of the cases. All the MDR-TB cases were positive for HIV and found to have a history of prior hospital admission. In our finding a relatively high prevalence of any drug resistance was observed and the overall prevalence of multidrug-resistant tuberculosis was 1.1%.The majority of drug-resistant isolates demonstrated common mutations. Heteroresistant strains were detected, signaling the existence of an M.tuberculosis population with variable responses to anti-tuberculosis drugs or of mixed infections.

Prevalence of multidrug-resistant tuberculosis in Latin America and the Caribbean: a systematic review and meta-analysis.

To evaluate the prevalence of multidrug-resistant tuberculosis (MDR-TB) in individuals living in Latin America and the Caribbean (LAC). We searched the MEDLINE, Embase and Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) databases until 08 August 2019 for all studies on the subject, without time or language restrictions. Original studies reporting the prevalence of infection with Mycobacterium tuberculosis resistant to isoniazid and rifampicin simultaneously (MDR) in LAC, the prevalence of resistance in cases with no previous treatment (new cases) and the prevalence of resistance in previously treated cases were selected. Considering the expected heterogeneity between studies, all analyses were performed using the random effects model, and heterogeneity was assessed using the I2 statistic. We included 91 studies from 16 countries. The estimated overall prevalence was 13.0% (95% CI 12.0-14.0%), and the heterogeneity between studies was substantial (I2 =96.1%). In the subgroup analyses, it was observed that the prevalence of MDR-TB among new cases was 7.0% (95% CI 6.0-7.0%) and in previously treated cases was 26.0% (95% CI 24.0-28.0%). This review highlights multidrug resistance to antituberculosis drugs in LAC, indicating that prevention strategies have not been effective. Government institutions should invest heavily in strategies for early diagnosis and the rapid availability of effective treatments and prioritise adequate protection for health professionals. In addition, screening programmes should be adopted to prevent secondary cases.

Multidrug-resistant tuberculosis surveillance and cascade of care in Madagascar: a five-year (2012\u20132017) retrospective study

BackgroundIn Madagascar, the multidrug-resistant tuberculosis (MDR-TB) surveillance programme was launched in late 2012 wherein previously treated TB cases and symptomatic MDR-TB contacts (hereafter called presumptive MDR-TB cases) undergo drug susceptibility testing. This retrospective review had per aim to provide an update on the national MDR-TB epidemiology, assess and enhance programmatic performance and assess Madagascar’s MDR-TB cascade of care.MethodsFor 2012–2017, national TB control programme notification, clinical management data and reference laboratory data were gathered. The development and coverage of the surveillance programme, the MDR-TB epidemiology and programmatic performance indicators were assessed using descriptive, logistic and spatial statistical analyses. Data for 2017 was further used to map Madagascar’s TB and MDR-TB cascade of care.ResultsThe geographical coverage and diagnostic and referral capacities of the MDR-TB surveillance programme were gradually expanded whereas regional variations persist with regard to coverage, referral rates and sample referral delays. Overall, the rate of MDR-TB among presumptive MDR-TB cases remained relatively stable, ranging between 3.9% in 2013 and 4.4% in 2017. Most MDR-TB patients were lost in the second gap of the cascade pertaining to MDR-TB cases reaching diagnostic centres but failing to be accurately diagnosed (59.0%). This poor success in diagnosis of MDR-TB is due to both the current use of low-sensitivity smear microscopy as a first-line diagnostic assay for TB and the limited access to any form of drug susceptibility testing. Presumptive MDR-TB patients’ sample referral took a mean delay of 28 days before testing. Seventy-five percent of diagnosed MDR-TB patients were appropriately initiated on treatment, and 33% reached long-term recurrence-free survival.ConclusionsAn expansion of the coverage and strengthening of MDR-TB diagnostic and management capacities are indicated across all regions of Madagascar. With current limitations, the surveillance programme data is likely to underestimate the true MDR-TB burden in the country and an updated national MDR-TB prevalence survey is warranted. In absence of multiple drivers of an MDR-TB epidemic, including high MDR-TB rates, high HIV infection rates and inter-country migration, Madagascar is in a favourable starting position for MDR-TB control and elimination.

\u201cDeath is a better option than being treated like this\u201d: a prevalence survey and qualitative study of depression among multi-drug resistant tuberculosis in-patients

BackgroundUnderstanding of the relationship between multi-drug resistant tuberculosis and mental health is limited. With growing prevalence of multi-drug resistant tuberculosis, addressing mental ill-health has potential to improve treatment outcomes and well-being. In several low and middle-income contexts hospitalisation during treatment is common. Understanding of the impact on mental ill-health are required to inform interventions for patients with multi-drug resistant tuberculosis.Our aim was to identify the prevalence of comorbid depression among in-patients being treated for multi-drug resistant tuberculosis and to explore their experiences of comorbid disease and the care they received in a large specialist chest hospital in Dhaka, Bangladesh.MethodsWe conducted a quantitative cross-sectional survey among 150 multi-drug resistant tuberculosis in-patients (new cases = 34%, previously treated = 66%) in 2018. A psychiatrist assessed depression was assessed with the Structured Clinical Interview for Depression (SCID DSM-IV). We used multi-level modelling to identify associations with depression. Experience Bangladeshi researchers conducted qualitative interviews with 8 patients, 4 carers, 4 health professionals and reflective notes recorded. Qualitative data was analysed thematically.ResultsWe found 33.8% (95% CI 26.7%; 41.7%) of patients were depressed. While more women were depressed 39.3% (95% CI 27.6%; 52.4%) than men 30.4% (95% CI 22%; 40.5%) this was not significant. After controlling for key variables only having one or more co-morbidity (adjusted odds ratio [AOR] = 2.88 [95% CI 1.13; 7.33]) and being a new rather than previously treated case (AOR = 2.33 [95% CI 1.06; 5.14]) were associated (positively) with depression. Qualitative data highlighted the isolation and despair felt by patients who described a service predominantly focused on providing medicines. Individual, familial, societal and health-care factors influenced resilience, nuanced by gender, socio-economic status and home location.ConclusionsPatients with multi-drug resistant tuberculosis are at high risk of depression, particularly those with co- and multi-morbidities. Screening for depression and psycho-social support should be integrated within routine TB services and provided throughout treatment.

Genetic diversity and drug resistance pattern of Mycobacterium tuberculosis strains isolated from pulmonary tuberculosis patients in the Benishangul Gumuz region and its surroundings, Northwest Ethiopia.

Tuberculosis (TB) remains a major global public health problem and is the leading cause of death from a single bacterium, Mycobacterium tuberculosis (MTB) complex. The emergence and spread of drug-resistant strains aggravate the problem, especially in tuberculosis high burden countries such as Ethiopia. The supposedly high initial cost of laboratory diagnosis coupled with scarce financial resources has limited collection of information about drug resistance patterns and circulating strains in peripheral and emerging regions of Ethiopia. Here, we investigated drug susceptibility and genetic diversity of mycobacterial isolates among pulmonary tuberculosis patients in the Benishangul Gumuz region and its surroundings in northwest Ethiopia. In a cross-sectional study, 107 consecutive sputum smear-positive pulmonary tuberculosis (PTB) patients diagnosed at two hospitals and seven health centers were enrolled between October 2013 and June 2014. Sputum samples were cultured at Armauer Hansen Research Institute (AHRI) TB laboratory, and drug susceptibility testing (DST) was performed against Isoniazid, Rifampicin, Ethambutol, and Streptomycin using the indirect proportion method. Isolates were characterized using polymerase chain reaction (PCR)based Region of Difference 9 (RD9) testing and spoligotyping. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) for Windows version 24.0. Of 107 acid-fast-bacilli (AFB) smear-positive sputum samples collected, 81.3% (87/107) were culture positive. A PCR based RD9 testing revealed that all the 87 isolates were M. tuberculosis. Of these isolates, 16.1% (14/87) resistance to one or more drugs was observed. Isoniazid monoresistance occurred in 6.9% (6/87). Multidrug resistance (MDR) was observed in two isolates (2.3%), one of which was resistant to all the four drugs tested. Spoligotyping revealed that the majority, 61.3% (46/75) of strains could be grouped into ten spoligotype patterns containing two to 11 isolates each while the remaining 38.7% (29/75) were unique. SIT289 (11 isolates) and SIT53 (nine isolates) constituted 43.5% (20/46) among clustered isolates while 29.3% (22/75) were ''New" to the database. The dominant families were T, 37% (28/75), CAS, 16.0% (12/75), and H, 8% (6/75), adding up to 51.3% (46/75) of all isolates identified. The current study indicates a moderate prevalence of MDR TB. However, the observed high monoresistance to Isoniazid, one of the two proxy drugs for MDR-TB, reveals the hidden potential threat fora sudden increase in MDR-TB if resistance to Rifampicin would increase. Clustered spoligotype patterns suggest ongoing active tuberculosis transmission in the area. The results underscore the need for enhanced monitoring of TB drug resistance and epidemiological studies in this and other peripheral regions of the country using robust molecular tools with high discriminatory power such as the Mycobacterial Interspersed Repetitive Units -Variable Number of Tandem Repeats (MIRU-VNTR) typing and whole-genome sequencing (WGS).

Prevalence of Multi-Drug Resistant Mycobacterium tuberculosis in Khyber Pakhtunkhwa - A High Tuberculosis Endemic Area of Pakistan.

Anti-tuberculosis therapy involves the combination of drugs to hamper the growth of Mycobacterium tuberculosis (MTB). The emergence of multidrug-resistant tuberculosis (MDR-TB) is a global concern. Pakistan has been ranked 5th position in terms of a high burden of MDR-TB in the world. The aim of the current study was to investigate the prevalence of drug resistance in MTB in Khyber Pakhtunkhwa. Random samples were collected from 25 districts using the simple random sampling formula. All samples were processed in a biosafety level 3 laboratory for culture and drug susceptibility testing. Among 5759 presumptive tuberculosis (TB) cases, 1969 (34%) were positive. The proportion of TB was higher in females (39%) than males (29%), thus it represents a significant association between gender and tuberculosis (p < 0.05). People ages between 25 to 34 years were more likely to be infected with MTB (40%). Drug-resistant profile showed 97 (4.9%) patients were infected with MDR-TB. Streptomycin resistance was the highest and was observed in 173 (9%) isolates followed by isoniazid in 119 (6%) isolates. The lowest resistance was observed to pyrazinamide (3%). The prevalence of MDR-TB (10.4%) among patients that previously received anti-tuberculosis treatment is seemingly high. A large-scale drug resistance survey is required to evaluate the drug resistance for better management of tuberculosis.

Determining Mycobacterium tuberculosis Drug Resistance and Risk Factors for Multidrug-Resistant Tuberculosis in Sputum Smear-Positive Tuberculosis Outpatients in Anhui Province, China, 2015-2016.

BackgroundMultidrug-resistant tuberculosis (MDR-TB) is currently a major problem in China. The prevention and treatment work for MDR-TB patients started late in Anhui province. To determine the prevalence of MDR-TB in sputum smear-positive TB patients (SSPTBPs) and analyze the risk factors for MDR-TB in Anhui province, we conducted an investigation of drug resistance among SSPTB outpatients from September 2015 to August 2016.MethodsA stratified cluster-randomized sampling method was used to obtain a representative sample. It was estimated that 2290 new cases and 440 previously treated cases of SSPTBPs needed to be recruited from 40 survey sites. Isolates were tested for resistance to six first-line and second-line anti-TB drugs. Information from patient questionnaire survey was used to identify factors linked to MDR-TB.ResultsFinally, a total of 3047 SSPTBPs were recruited from 40 survey sites; of these, 2530 specimens were successfully cultured and had drug susceptibility testing done. The proportions of rifampin resistant (RR)-TB were 11.42% (289/2530, 95% CI: 10.18–12.66%), 7.64% (163/2133, 95% CI: 6.38–8.62%) and 31.74% (126/397, 95% CI: 27.38–36.60%) in all cases, new cases and previously treated cases, respectively, and the proportions of confirmed MDR-TB were 7.63% (193/2530, 95% CI: 6.59–8.66%), 4.97% (106/2133, 95% CI: 4.05–5.89%) and 21.91% (87/397, 95% CI: 17.83–26.00%), respectively. The ofloxacin resistance rate in previously treated SSPTBPs reached 21.66% (95% CI: 17.33–26.75%). Patients who had received two or more anti-TB treatment courses were significantly associated with MDR-TB compared to patients who have received one anti-TB course.ConclusionMDR-TB prevalence was high among SSPTBPs in Anhui province, and past anti-TB treatment course was associated with MDR-TB.

Challenge of the Rising Multidrug-Resistant Tuberculosis in China: A Predictive Study Using Markov Modeling

Background: Multidrug-resistant tuberculosis (MDR-TB) is emerging in China. We used a dynamic Markov model to predict the longitudinal trends of MDR-TB in China by 2050, and assess the effects of alternative control measures. Methods Eight states of TB transmission were set up in the Markov model using a hypothetical cohort of 100,000 people. Prevalence of MDR-TB and bacteriological confirmed drug-susceptible TB (DS-TB+) were simulated. MDR-TB was stratified into being treated with the recommended regimen or not. Findings: Under the current China’s TB control conditions, by 2050, prevalence of DS-TB+ could be estimated to decrease to 39 per 100,000 people, a 37·1% reduction from 2019 , whereas MDR-TB would increase by three times to 58/100,000. Furthermore, by the year of 2050, 86·2% of the MDR-TB cases would be left untreated. If the detection rate of MDR-TB could reach 50% or 70% at 5% per year, the decline of MDR-TB prevalence would be 25·9% and 36·2% respectively. If treatment coverage was improved to 70% or 100% by 5% yearly , MDR-TB prevalence in 2050 would gain a reduction of 13·8% and 24·1%, respectively. If both detection rate and treatment coverage could reach 70%, the prevalence of MDR-TB would be reduced to 28/100, 000, a 51·7% reduction by 2050. Interpretation: MDR-TB, especially untreated MDR-TB, would rise rapidly under current MDR-TB control strategies in China. Interventions on promoting effective detection and treatment of MDR-TB are imperative in the fights against MDR-TB epidemics. Funding Statement: The Sweden-China (VR-NSFC) joint project (PI, Biao Xu, 81361138019 and Sven Hoffner, 540-2013-8797). Declaration of Interests: The authors stated: None declared. Ethics Approval Statement: Not required.

Epidemiology of drug-resistant tuberculosis in Bahrain, five years review

Introduction: Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide, drug resistance is one of the major contributors to that. No existing published data about the burden of Multi-Drug Resistant (MDR) TB in the kingdom of Bahrain, the aim of our study is to estimate the prevalence of MDR TB in the kingdom and to define its resistance profile.

Multidrug Resistant Mycobacterium tuberculosis Among Military and Civilian Personnel seen at a Tertiary Military Hospital, Manila, Philippines (2015-2018).

About one third of the world population is estimated to be infected with Mycobacterium tuberculosis (MTB), and this proportion is expected to be higher in countries with a high tuberculosis (TB) burden. The Philippines is both a high tuberculosis burden and a high multidrug resistant tuberculosis (MDR-TB) burden country. Though TB has been extensively described in the civilian population, there is limited data on TB in the military population. The objectives are: (1) To determine MTB/MDR-TB prevalence among military and civilian patients in the Philippines presenting with clinically suspected TB in a tertiary military hospital and (2) To determine performance of direct sputum smear microscopy (DSSM) using Ziehl-Neelsen (ZN) staining compared to Xpert MTB/RIF real-time reverse transcriptase polymerase chain reaction. Sputum samples were obtained from patients, clinically suspected with TB, and/or with TB associated signs/symptoms. Sputum specimens were tested using DSSM with ZN staining and Xpert MTB/RIF assay (Cepheid, Sunnyvale, California) and patient demographic and clinical data were collected. From March 2015 to December 2018, a total of 795 (173 military personnel [164 active duty and 9 retired]; 618 civilians; and 4 with no data on military/civilian status) patients with TB associated symptoms or clinically suspected with TB were tested. Overall, MTB prevalence was 81/795 (10%). MTB prevalence among active duty and retired military personnel were 27/164 (16%) and 4/9 (44%), respectively while MTB prevalence for civilian patients was 50/618 (8%) (p value=0.0003; OR=2.48 [95% C.I. 1.5-4]). Among active and retired military personnel who tested positive for MTB, rifampin resistance was 4/27 (15%) and 1/4 (25%), respectively, while rifampin resistance for civilian patients was 9/50 (18%) (p value=1; OR=0.88 [95% C.I. 0.26-2.90]). For active duty military personnel, average MTB prevalence (based on Xpert MTB/RIF) covering years 2015-2018 was 21% and ranged from 13% to 35%, while average rifampin resistance among MTB positive active duty military personnel was 15% and ranged from 0% to 25%. Overall sensitivity and specificity of DSSM compared to Xpert MTB/RIF were 70% and 96%, respectively. Positive and negative predictive values of DSSM to accurately categorize MTB in symptomatic cases (with Xpert MTB/RIF as "true positive" reference) were 74% and 95%, respectively. Performance of DSSM varied according to MTB load detected by Xpert MTB/RIF with increasing DSSM sensitivity observed as the MTB load detected by Xpert MTB/RIF increased (p=0.02). This report describes high MTB and MDR-TB prevalence rates among symptomatic military patients with military personnel having higher odds of MTB infection compared to the civilian patients in the study. Since DSSM (ZN) sensitivity greatly varied depending on MTB load, the Xpert MTB/RIF should be used as a first-line diagnostic tool to identify MTB and detect rifampin resistance among presumptive TB cases instead of DSSM (ZN) microscopy.

Prevalence of Multidrug-Resistant Tuberculosis at a Regional Drug-Resistant Tuberculosis Center of Maharashtra

Introduction: Multidrug-resistant tuberculosis (MDR-TB) has created a significant health problem in most of the countries, and it is an obstacle to effective TB control. Aims and Objectives: The study aims to study the prevalence of MDR-TB among new cases, retreatment cases and to study the rate of MDR-TB detection among suspected cases of Category I (CAT I) failure, CAT II failure and at the start of CAT II. Patients and Methods: The present retrolective study was conducted by reviewing the records of diagnosed MDR-TB patients at a drug-resistant TB center from January 2012 to December 2013. The data of new and retreatment pulmonary TB (PTB) cases diagnosed during that period were collected. The data were analyzed to find out the prevalence of MDR-TB, and the rate of MDR-TB detected among each CAT. Results: The prevalence of MDR-TB in new cases was 0.10% and that of retreatment cases was 4.3%. The rate of MDR-TB detection among suspected cases of CAT I failure was 16.8%, 52.4% in CAT II failure, 11.6% at the start of CAT II, 11.7% among sputum positive during any month follow-up, 6.6% among MDR-TB contacts. Conclusion: Timely suspicion and diagnosis of MDR-TB and treatment are important in new and retreatment cases. All relapse or defaulter patients should be screened for MDR-TB at the start of CAT II treatment. MDR-TB should be suspected in any sputum-positive TB patient during treatment/sputum positive relapse/defaulter PTB.

Mycobacterium tuberculosis burden, multidrug resistance pattern, and associated risk factors among presumptive extrapulmonary tuberculosis cases at Dessie Referral Hospital, Northeast Ethiopia

Background Tuberculosis (TB) represents one of the major challenges to global health. TB is usually classified based on the disease symptoms and the site of infection. Two types of clinical manifestation of TB are pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB). Objective This study aimed at determining Mycobacterium tuberculosis and multidrug-resistant tuberculosis (MDR-TB) burden among presumptive EPTB cases and associated risk factors at Dessie Referral Hospital, North West Ethiopia. Methods A cross-sectional study was conducted from February to April, 2018. A total of 337 presumptive EPTB cases in Dessie Referral Hospital were included using convenient sampling. Data were collected using a prestructured questionnaire. Body fluid specimens were collected and processed. Cytology, GeneXpert, and GenoType MTBDR plus Line Probe Assays were used for the detection of MTB and MDR-TB. Data were entered and cleared by Epi data version 3.1 and analyzed using SPSS, version 21. Multivariate analysis was done. P value less than 0.05 at 95% confidence interval was considered as statistically significant. Results The overall prevalence of EBTB using GeneXpert and cytopathological technique was 23.4, 27.3%, respectively. TB lymphadenitis (48 and 53.3%, respectively) was the dominant type followed by pleural (27 and 25%, respectively) and peritoneal (24% and 21.7%, respectively) by GeneXpert and cytology. The prevalence of MDR-TB was one (1.3%). Previous history of PTB (P Conclusion High prevalence of EPTB (27.3%) was reported, and 1.3% of them were MDR-TB. TB lymphadenitis was dominant. History of previous PTB and HIV was significantly associated with EPTB. Therefore, clinicians, public health professionals, and health programmers should give attention to EPTB case finding, treatment as well as prevention and control of EPTB by adhering guidelines of the ministry of health and WHO recommendations.

Prevalence of multidrug-resistant tuberculosis and causes in Saudi Arabia: a review

This review aims to evaluate the current status of multidrug-resistant tuberculosis (MDR-TB) in the Kingdom of Saudi Arabia, comparing it to that of the other countries. In addition, the important causes of tuberculosis (TB) resistance prevalence are discussed, and the need for further research in the development of MDR-TB resistance is evaluated. To evaluate the current status of MDR-TB in Saudi Arabia, data from previous studies of MDR-TB in Saudi Arabia were collected and compared with data collected worldwide regarding the same disease. In the study, various factors that affect the prevalence of MDR-TB were considered, and a brief review of MDR-TB complications is given. Many causes of MDR-TB prevalence in Saudi Arabia are illegal immigration, the misuse of antibiotics by the patients, and the incorrect prescription by the healthcare providers.

Prevalence of Multidrug Resistance Mycobacterium Bovis in Human: A Systematic Review and Meta-Analysis

Introduction: Human infection with multidrug resistant mycobacterium bovis (MDR-M.bovis) is very rare. Recently, infection with this type of bacteria has been described. The WHO strategy to end TB by 2035, recall for more efforts in the diagnosis and treatment of mycobacterium bovis particularly in resource limited countries. The aim of this systematic review was to determine the prevalence of multidrug resistant tuberculosis M.bovis infects human. Methods: International database including Medline, EMBASE, and Web of Sciences, Scopus, and ScienceDirect were searched for related literature. Google Scholar searching engines as well as references list were explored. Studies met the inclusion criteria were included in the systematic review. Random effects model was used to estimate the pooled prevalence. Results: A total number of (4275) studies were retrieved and nine studies were included in the meta analysis. The overall estimated prevalence of the multidrug resistant Mycobacterium bovis was 0.04 (95% CI: 0.02, 0.06). Based one study quality, time and area of study, subgroup analysis were conducted to check for heterogeneity. The prevalence of MDR- M bovis in low quality studies was 0.04 (95% CI: 0.00, 0.06), and in high quality studies was 0.05 (95% CI: 0.02, 0.08). Conclusions: The finding of this study indicated that the prevalence of multidrug resistant M.bovis in human is low. However, more attention is needed in the diagnosis and treatment of M.bovis infection in Human. Keywords: Tuberculosis, Multidrug-Resistant Mycobacterium bovis review meta-analysis Human DOI : 10.7176/JHMN/69-01 Publication date: December 31 st 2019

Prevalence of Multidrug-Resistant Tuberculosis (MDR-TB) and Laboratory Efficiency in Detection in Kano State, North West Nigeria, 2018

Prevalence of Multidrug-Resistant Tuberculosis (MDR-TB) and Laboratory Efficiency in Detection in Kano State, North West Nigeria, 2018

Prevalence of multidrug-resistant tuberculosis in suspected childhood tuberculosis in Shandong, China: a laboratory-based study.

ObjectiveCurrently, the prevalence of multidrug-resistant tuberculosis (MDR-TB) in childhood tuberculosis (TB) in Shandong, China remains unclear. We retrospectively conducted laboratory-based surveillance in a high TB burden district, to analyze the local prevalence of MDR-TB in childhood TB.MethodsWe collected data, including microbiological results and demographic and disease information, using a questionnaire and medical records. We used the chi-squared test to compare the prevalence of MDR-TB in childhood TB between two periods: 2008 to 2013 and 2014 to 2018.ResultsIn Shandong, the prevalence of MDR-TB in childhood TB was low, at 5.6%. Between 2008-2013 and 2014-2018 among children with TB, the prevalence of MDR-TB remained unchanged, the proportion with pulmonary TB decreased from 78.3% to 64.9%, and the proportion with a TB contact history decreased from 20.5% to 9.9%.ConclusionsThe prevalence of MDR-TB among childhood TB in Shandong, China was low and has remained stable over the past years. However, non-tuberculous mycobacterial diseases may be a new challenge in the management of suspected childhood TB.

Prevalence of multi-drug resistant (MDR) pulmonary tuberculosis in a tertiary care rural hospital in Western Maharashtra, India

Prevalence of multi-drug resistant (MDR) pulmonary tuberculosis in a tertiary care rural hospital in Western Maharashtra, India - IJMR- Print ISSN No: - 2394-546X Online ISSN No:- 2394-5478 Article DOI No:- 10.18231/j.ijmr.2019.052, Indian Journal of Microbiology Research-Indian J Microbiol Res

Prevalence and Factors Associated with Multidrug-Resistant Tuberculosis (MDR-TB) among Presumptive MDR-TB Patients in Tigray Region, Northern Ethiopia.

Background Tuberculosis (TB) is one of the major public health problems. There are alarming reports of increasing multidrug-resistant tuberculosis (MTR-TB) from various parts of the globe, including Ethiopia. This study was designed to determine the prevalence and factors associated with MDR-TB among presumptive MDR-TB cases in Tigray Regional State, Ethiopia. Methods A cross-sectional study was conducted in Tigray Regional State from 2015 to 2016. Two hundred sputum samples were collected, transported, processed using 2% N-acetyl-L-cysteine-sodium hydroxide, and cultured in LJ medium. Besides, the microscopic examination was performed after ZN staining. Moreover, drug susceptibility test was done using molecular line probe assay. Descriptive statistics and binary and multivariable logistic regression were done. A statistical test was regarded as significant when the P value was <0.05. Results The prevalence of MDR-TB was found to be 18.5%. About one-fourth (26.5%) of the study participants had sputum smear positive for acid-fast bacilli (AFB). TB culture was positive in 37% of the samples, and rifampicin mono-resistant cases accounted for 3.5% of the presumptive MDR-TB cases. Three (1.5%) were new MDR-TB cases, while the rest had been treated previously for TB. Most (63.5%) of the MDR-TB cases were from 15 to 44 years of age. Age was associated with MDR-TB with a crude odds ratio of 1.06 (CI: 1.02–1.10) and adjusted odds ratio of 1.06 (CI: 1.00–1.11). Conclusions The prevalence of MDR-TB was found to be high. Preventive measures should be taken to prevent the transmission of MDR-TB in the community.

Prevalence of multi-drug-resistant tuberculosis among human immunodeficiency virus and nonhuman immunodeficiency virus-positive pulmonary tuberculosis patients of two referral hospitals in Southeast Nigeria

Introduction: Multidrug-resistant tuberculosis (MDR-TB) is a type of TB that is resistant to the two most effective first-line drugs: rifampicin and isoniazid and it remains a major public health threat, particularly in developing countries. Objectives: To assess the MDR-TB prevalence among human immunodeficiency virus (HIV) and nonHIV positive pulmonary TB patients of two referral hospitals in southeast Nigeria. Materials and Methods: Sputum specimens of individuals presenting with a cough of &gt;2 weeks duration were screened by Ziehl–Neelsen technique for the presence of acid-fast bacilli (AFB). Results: A total of 103 subjects with AFB-positive sputum samples were recruited from the two referral hospitals and HIV-1/2 antibodies were screened using serial algorithm method. The positive sputum samples were subjected to Xpert MTB/RIF assay (GeneXpert®, Cepheid, USA) and cultured on the Lowenstein–Jensen medium for 42 days at 37°C. Drug susceptibility testing was done on the isolates using the nitrate reduction assay. Eighty-three (80.6%) of the isolates were obtained from culture after suspected colonies were subjected to morphological, biochemical, and immunological tests and of the 83 (80.6%) samples analyzed using Xpert MTB/RIF assay 45 (67.2%) were rifampicin-resistant. The prevalence of culture-positive TB was higher in the HIV-negative sub-population (82.02%) when compared with the HIV-positive participants (71.40%). The rate of MDR-TB was high among HIV-positive patients though not statistically significant. HIV positive patients showed prevalence of (66.70%), whereas HIV-negative patients had (42.60%). Conclusions: The World Health Organization estimated that 26% of patients with TB infection in Nigeria are HIV-positive and the alarming evidence of MDR-TB prevalence in this study calls for close monitoring of the prevalence of drug resistance, especially in HIV-infected population.