Free Content First- and second-line anti-tuberculosis drug resistance in Northwest Ethiopia

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Abstract:

SETTING: Gondar Hospital, Gondar Health Centre, Metemma Hospital, Bahir Dar Hospital and Debre Markos Hospital in Northwest Ethiopia.

OBJECTIVE: To assess the level of and risk factors for first- and second-line drug resistance among tuberculosis (TB) patients.

DESIGN: Drug susceptibility testing (DST) against first-line drugs, including isoniazid (INH), rifampicin (RMP), streptomycin (SM), ethambutol (EMB) and pyrazinamide (PZA), was performed using the BacT/ALERT 3D system. DST against second-line drugs, including fluoroquinolones and aminoglycocides/cyclic peptides, was performed using GenoType MTBDRsl.

RESULTS: Of 260 Mycobacterium tuberculosis isolates, 41 (15.8%) were resistant to at least one first-line drug, 13 (5.0%) were multidrug-resistant (MDR) and 9 (3.5%) were resistant to all first-line drugs. Any resistance to INH, RMP, SM, EMB and PZA was respectively 36 (13.8%), 15 (5.8%), 26 (10.0%), 19 (7.3%) and 12 (4.6%). Of 214 new and 46 previously treated cases, respectively 8 (3.7%) and 5 (10.9%) were MDR. All isolates were susceptible to all second-line drugs.

CONCLUSION: A substantial number of new and previously treated cases harbour MDR-TB. We recommend DST at least for previously treated cases, patients who remain smear-positive at the end of the second month of treatment and patients in close contact with MDR-TB cases. Improved infection control measures need to be implemented in Ethiopia.

Keywords: drug resistance; first-line anti-tuberculosis drugs; second-line anti-tuberculosis drugs; tuberculosis

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.11.0522

Affiliations: 1: Department of Medical Laboratory Technology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital of Leipzig, Leipzig, Germany; Institute of Clinical Immunology, University Hospital of Leipzig, Leipzig, Germany 2: Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital of Leipzig, Leipzig, Germany 3: Institute of Clinical Immunology, University Hospital of Leipzig, Leipzig, Germany; Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany

Publication date: June 1, 2012

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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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