Relatively low primary resistance to anti-tuberculosis drugs in Bangui and Bimbo, Central African Republic

Abstract

Setting: The Central African Republic (CAR) is a country with a high burden of tuberculosis (TB). Although its national tuberculosis programme is effective, there is no continuous surveillance system for anti-tuberculosis drug resistance in place.

Objective: To establish base-line anti-tuberculosis drug resistance data to allow for future monitoring of trends and evolutions. More specifically, we aimed at investigating primary anti-tuberculosis drugs in Bangui and Bimbo, two cities of CAR.

Method: A total of 225 Mycobacterium tuberculosis isolates were tested for susceptibility to the anti-tuberculosis drugs commonly used in the country (isoniazid [INH, H], rifampicin [R], streptomycin [SM, S] and ethambutol [EMB, E]). Human immunodeficiency virus co-infection was recorded.

Results: Overall primary drug resistance was found to be 14.7% (33/225). The highest rate of primary resistance was for INH (9.3%), followed by SM (8.4%), and EMB (2.2%). The multidrug resistance rate was 0.4%.

Conclusion: Our study indicates that primary drug resistance levels in urban settings of CAR are similar to or lower than in other African cities, and that the spread of multidrug-resistant TB in this population is limited. Extended nationwide monitoring of drug resistance remains important, especially in view of the planned introduction of a new treatment regimen (2HRZE/4HR [Z = pyrazinamide]).