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Free Content Results of a national survey on drug resistance among pulmonary tuberculosis patients in Rwanda

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Abstract:

BACKGROUND: One of the principal objectives of tuberculosis (TB) control is to minimise the emergence of drug resistance. The first national survey was conducted in Rwanda to determine the prevalence of M. tuberculosis drug resistance.

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.

Keywords: Rwanda; acquired resistance; national survey; primary resistance; tuberculosis

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: February 1, 2007

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  • 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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