Characteristics of drug resistance and HIV among tuberculosis patients 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.
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
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