Authors: Chacón, L.¹; Lainez, M.¹; Rosales, E.¹; Mercado, M.¹; Caminero, J.A.²

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 1, January 2009 , pp. 62-67(6)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: Nicaragua, a country where the DOTS strategy has been successfully implemented since 1984.

OBJECTIVE: To estimate the prevalence and trends of Mycobacterium tuberculosis resistance to first-line anti-tuberculosis drugs.

DESIGN: A prospective national survey carried out in 2004 according to the standardised model developed by the World Health Organisation and the International Union Against Tuberculosis and Lung Disease.

RESULTS: A total of 423 M. tuberculosis strains were studied. Among the 320 strains evaluated for initial resistance, 13.1% displayed resistance to any drug, lower than the 1998 figure of 15.6%. Overall initial resistance to isoniazid (INH), rifampicin (RMP) and multidrug resistance (MDR) was respectively 6.6%, 0.9% and 0.6%. Initial resistance was higher in older age groups. Overall acquired resistance was 35.9% (n = 103); resistance to INH was 29.3% and to RMP 8.9%, while MDR was 7.9%. The acquired MDR rate was clearly higher in Category I failures (44.4%) than in relapses (3.8%) and retrieved defaulters (2.7%). All resistance rates found in this study were lower than those detected in 1998.

CONCLUSION: This study shows low rates of resistance and MDR and a downward trend in all rates, undoubtedly related to the proper implementation of the National Tuberculosis Programme.

Keywords: Nicaragua; multidrug resistance; initial resistance; MDR-TB

Document Type: Regular paper

Affiliations: 1: Departamento de Micobacterias, Centro Nacional de Diagnóstico y Referencia (CNDR), Ministerio de Salud (MINSA), Managua, Nicaragua 2: Servicio de Neumología, Hospital General de Gran Canaria `Dr. Negrín', Las Palmas de Gran Canaria, Spain; and International Union Against Tuberculosis and Lung Disease, Paris, France

Publication date: 2009-01-01

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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.

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