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Free Content Characteristics of drug resistance and HIV among tuberculosis patients in Mozambique

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Abstract:

SETTING: The rate of human immunodeficiency virus (HIV) seroprevalence among tuberculosis patients varies between 2% and 53% in Mozambique, depending on the region. Drug resistance surveillance has been performed in only a few cities in Mozambique.

OBJECTIVES: To establish the extent of drug resistance in areas of Mozambique with different levels of HIV prevalence, to estimate the prevalence of HIV among tuberculosis (TB) patients, and to examine the association between drug resistance and HIV infection.

DESIGN: All tuberculosis patients diagnosed at randomly selected health facilities over 9 months (September 1998 to June 1999) were enrolled in the study. Sputum was collected, smeared and cultured, and drug susceptibility tests were performed. Blood was tested for HIV in the respective provinces, and patients received pre-test and post-test counselling.

RESULTS: Of 709 culture-positive cases, 25.5% were HIV-positive. HIV-positive patients were significantly more likely to have a prior history of treatment (OR 2.2; 95%CI 1.9–3.6) and resistance to both isoniazid and streptomycin (OR 2.3; 95%CI 1.3, 4.5). In patients with no history of prior tuberculosis treatment, the multidrug resistance rate was 3.4% and resistance to isoniazid and streptomycin (HS) was 5.2%. Any drug resistance was significantly more common among those with a history of prior treatment (OR 3.1; 95%CI 2.1–4.7), particularly resistance to HS (OR 4.5; 95%CI 2.6–7.9).

CONCLUSIONS: This study demonstrates substantial levels of drug resistance in Mozambique. Differences in drug resistance between high and low HIV prevalence areas may be related to prior treatment.

Keywords: HIV; Mozambique; drug resistance; tuberculosis patients

Document Type: Regular Paper

Affiliations: 1: National Tuberculosis and Leprosy Control Programme, Ministry of Health of Mozambique, Maputo, Mozambique 2: Department of Epidemiology and Medicine, School of Public Health, University of Washington, Seattle, Washington, USA 3: Sexually Transmitted Diseases and AIDS Control Programme, Department of Epidemiology, Ministry of Health of Mozambique, Maputo, Mozambique

Publication date: October 1, 2001

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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