Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali
METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RR-TB.
RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7–3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDA-negative at 2M (P = 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%.
CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.
Keywords: FDA; Mali; rpoB; sequencing
Document Type: Research Article
Affiliations: 1: University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali, Unit of Mycobacteriology, Institute of Tropical Medicine Antwerp, Antwerp 2: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Antwerp, Research Foundation Flanders, Brussels, Belgium 3: University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali 4: Laboratoire National de Référence des Mycobactéries, Institut National de Recherche en Santé publique, Bamako, Mali 5: Global Health, Northwestern University, Chicago, IL, USA 6: Laboratoire d´analyses Médicales et Hygiène Hospitalière du Centre Hospitalier Universitaire du Point-G, Bamako, Mali 7: Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA 8: Service de Pneumo-phtisiologie du Centre Hospitalier Universitaire du Point-G, Bamako 9: Programme National de Lutte contre la Tuberculose (PNLT), Ministère de la santé et des Affaires Sociales, Bamako, Mali 10: Independent Consultant, Leuven, Belgium 11: Unit of Mycobacteriology, Institute of Tropical Medicine Antwerp, Antwerp, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium 12: Unit of Mycobacteriology, Institute of Tropical Medicine Antwerp, Antwerp
Publication date: August 1, 2020
The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.
The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.
- Editorial Board
- Information for Authors
- Subscribe to this Title
- International Journal of Tuberculosis and Lung Disease
- Public Health Action
- Ingenta Connect is not responsible for the content or availability of external websites
Receive new issue alert- Access Key
- Free content
- Partial Free content
- New content
- Open access content
- Partial Open access content
- Subscribed content
- Partial Subscribed content
- Free trial content