Anti-tuberculosis drug resistance in Madagascar in 1994–1995
Abstract:SETTING: A new tuberculosis control programme has been implemented in Madagascar since 1991. A survey on Mycobacterium tuberculosis resistance to the major drugs was conducted between August 1994 and December 1995.
OBJECTIVE: To determine primary and acquired resistance in pulmonary tuberculosis patients in four main cities.
DESIGN: Were included 401 randomly sampled new smear positive patients (36.2% of declared new patients) and 137 recurrent cases (72.9% of declared cases) from 8 centres. Drug susceptibility testing was performed on Löwenstein Jensen medium according to the proportion method.
RESULTS: The male to female ratio was 1.35:1 in new patients (age range 11–74 years) and 1.98:1 in recurrent patients (age range 16–76 years). The primary resistance rate to any drug was 20% (95% Confidence Interval [CI] 16–23) and the acquired resistance rate 40% (95% CI 32–48, P < 2.10−7). Primary resistance to one drug was 18% (95% CI 15–22), mainly attributable to streptomycin resistance (14.5%). Multidrug resistance (MDR) to isoniazid and rifampicin was 0.25% (95% CI 0–0.7) for primary resistance and 5% (95% CI 2.6–10.6) for secondary resistance. No difference was observed between sexes or ages.
CONCLUSION: This survey conducted in big cities gives a very negative picture of resistance in Madagascar.
Document Type: Regular Paper
Affiliations: 1: Institut Pasteur, Antananarivo, Madagascar 2: Institut Pasteur, Antananarivo, Madagascar; and Programme National de Lutte contre la Tuberculose, Antananarivo, Madagascar 3: Programme National de Lutte contre la Tuberculose, Antananarivo, Madagascar
Publication date: October 1, 1997
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