1. Prevalence of drug-resistant tuberculosis in Zimbabwe: A health facility-based cross-sectional survey.
- Author
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Timire C, Metcalfe JZ, Chirenda J, Scholten JN, Manyame-Murwira B, Ngwenya M, Matambo R, Charambira K, Mutunzi H, Kalisvaart N, and Sandy C
- Subjects
- Adolescent, Adult, Aged, Anti-Bacterial Agents pharmacology, Child, Cross-Sectional Studies, Drug Resistance, Bacterial, Female, Health Facilities, Humans, Isoniazid pharmacology, Male, Microbial Sensitivity Tests, Middle Aged, Mycobacterium tuberculosis genetics, Prevalence, Rifampin pharmacology, Risk Factors, Sensitivity and Specificity, Sputum microbiology, Surveys and Questionnaires, Tuberculosis, Multidrug-Resistant epidemiology, Young Adult, Zimbabwe epidemiology, Mycobacterium tuberculosis drug effects, Mycobacterium tuberculosis isolation & purification, Tuberculosis, Multidrug-Resistant microbiology
- Abstract
Objective: To determine the prevalence of resistance to rifampicin alone; rifampicin and isoniazid, and second-line anti-TB drugs among sputum smear-positive tuberculosis patients in Zimbabwe., Design: A health facility-based cross-sectional survey., Results: In total, 1114 (87.6%) new and 158 (12.4%) retreatment TB patients were enrolled. MTB was confirmed by Xpert MTB/RIF among 1184 (93%) smear-positive sputum samples. There were 64 samples with Xpert MTB/RIF-determined rifampicin resistance. However, two were rifampicin susceptible on phenotypic drug susceptibility testing. The prevalence of RR-TB was [4.0% (95% CI, 2.9, 5.4%), n=42/1043) and 14.2% (95% CI, 8.9, 21.1%; n=20/141) among new and retreatment patients, respectively. The prevalence of MDR-TB was 2.0% (95% CI, 1.3, 3.1%) and 6.4% (95% CI, 2.4, 10.3%) among new and retreatment TB patients, respectively. Risk factors for RR-TB included prior TB treatment, self-reported HIV infection, travel outside Zimbabwe for ≥one month (univariate), and age <15 years. Having at least a secondary education was protective against RR-TB., Conclusion: The prevalence of MDR-TB in Zimbabwe has remained stable since the 1994 subnational survey. However, the prevalence of rifampicin mono-resistance was double that of MDR-TB., (Copyright © 2019. Published by Elsevier Ltd.)
- Published
- 2019
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