Results of a national survey on drug resistance among pulmonary tuberculosis patients in Rwanda
METHODS: Sputum samples were collected from all new and retreatment cases in the health districts from November 2004 to February 2005. Drug susceptibility testing of isolates against first-line drugs was performed by the proportion method.
RESULTS: Of 616 strains from new cases, 6.2% were resistant to isoniazid, 3.9% to rifampicin and 3.9% were multidrug-resistant TB. Among 85 strains from previously treated cases, the prevalence of resistance was respectively 10.6%, 10.6% and 9.4% (MDR-TB strains). Eight MDR cases showed additional resistance to ethambutol and streptomycin.
CONCLUSION: The level of MDR-TB among TB patients in Rwanda is high. The main reasons of this emergence of MDR-TB can be attributed to the disorganisation of the health system, migration of the population during the 1994 civil war and poor success rates, with a high number of patients transferred out and lost to follow-up. On the other hand, the use of treatment regimens administered twice weekly during the continuation phase could be another important factor and merit further investigations.
Document Type: Regular Paper
Affiliations: 1: National University of Rwanda, Butare, Rwanda; and Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium 2: Columbia University Mailman School of Public Health, International Center for AIDS Care and Treatment Programmes, Kigali, Rwanda 3: National Tuberculosis and Leprosy Control Programme, Rwanda Ministry of Health, Kigali, Rwanda 4: School of Public Health, National University of Rwanda, Kigali, Rwanda 5: National Reference Laboratory, Rwanda Ministry of Health, Kigali, Rwanda 6: World Health Organization, Kigali, Rwanda 7: Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium 8: Department of Microbiology, Erasme Hospital, Brussels, Belgium
Publication date: 2007-02-01
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