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. 2019 Oct:87:119-125.
doi: 10.1016/j.ijid.2019.07.021. Epub 2019 Jul 27.

Prevalence of drug-resistant tuberculosis in Zimbabwe: A health facility-based cross-sectional survey

Collins Timire  1 , John Z Metcalfe  2 , Joconiah Chirenda  3 , Jerod N Scholten  4 , Barbara Manyame-Murwira  5 , Mkhokheli Ngwenya  6 , Ronnie Matambo  7 , Kelvin Charambira  7 , Herbert Mutunzi  5 , Nico Kalisvaart  4 , Charles Sandy  8
Affiliations

Prevalence of drug-resistant tuberculosis in Zimbabwe: A health facility-based cross-sectional survey

Collins Timire et al. Int J Infect Dis. 2019 Oct.

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.

Keywords: Drug resistant TB; Gene Xpert; MDR; Previously treated TB; Rifampicin resistant TB; Zimbabwe.

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Conflict of interest statement

Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Flow of participants who were enrolled in the Zimbabwe DRS 2015–2016. MDR-TB = multi-drug resistant TB; FQ = Fluoroquinolone; XDR-TB = extensively drug resistant TB; RMR = rifampicin mono-resistant TB; Poly-resistant = resistance to >one first-line anti-TB drug, other than both isoniazid and rifampicin.
See this image and copyright information in PMC

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