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. 2022 Oct;27(10):891-901.
doi: 10.1111/tmi.13814. Epub 2022 Sep 11.

The second national anti-tuberculosis drug resistance survey in Tanzania, 2017-2018

Beatrice Kemilembe Mutayoba  1   2 , Julia Ershova  3 , Eligius Lyamuya  4 , Michael Hoelscher  2 , Norbert Heinrich  2 , Andrew Martin Kilale  5 , Nyagosya Segere Range  5 , Benard James Ngowi  6 , Nyanda Elias Ntinginya  7 , Saidi Mwinjuma Mfaume  5 , Emmanuel Nkiligi  8 , Basra Doulla  9 , Johnson Lyimo  8 , Riziki Kisonga  10 , Amri Kingalu  8 , Yakobo Lema  5 , Zuwena Kondo  8 , Michel Pletschette  2
Affiliations

The second national anti-tuberculosis drug resistance survey in Tanzania, 2017-2018

Beatrice Kemilembe Mutayoba et al. Trop Med Int Health. 2022 Oct.

Abstract

Objective: To determine the levels and patterns of resistance to first- and second-line anti-tuberculosis (TB) drugs among new and previously treated sputum smear positive pulmonary TB (PTB) patients.

Methods: We conducted a nationally representative cross-sectional facility-based survey in June 2017-July 2018 involving 45 clusters selected based on probability proportional to size. The survey aimed to determine the prevalence of anti-TB drug resistance and associated risk factors among smear positive PTB patients in Tanzania. Sputum samples were examined using smear microscopy, Xpert MTB/RIF, culture and drug susceptibility testing (DST). Logistic regression was used to account for missing data and sampling design effects on the estimates and their standard errors.

Results: We enrolled 1557 TB patients, including 1408 (90.4%) newly diagnosed and 149 (9.6%) previously treated patients. The prevalence of multidrug-resistant TB (MDR-TB) was 0.85% [95% confidence interval (CI): 0.4-1.3] among new cases and 4.6% (95% CI: 1.1-8.2) among previously treated cases. The prevalence of Mycobacterium tuberculosis strains resistant to any of the four first-line anti-TB drugs (isoniazid, rifampicin, streptomycin and ethambutol) was 1.7% among new TB patients and 6.5% among those previously treated. Drug resistance to all first-line drugs was similar (0.1%) in new and previously treated patients. None of the isolates displayed poly-resistance or extensively drug-resistant TB (XDR-TB). The only risk factor for MDR-TB was history of previous TB treatment (odds ratio = 5.7, 95% CI: 1.9-17.2).

Conclusion: The burden of MDR-TB in the country was relatively low with no evidence of XDR-TB. Given the overall small number of MDR-TB cases in this survey, it will be beneficial focusing efforts on intensified case detection including universal DST.

Keywords: MDR-TB; Tanzania; drug resistance; survey; tuberculosis.

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Figures

FIGURE 1
FIGURE 1
Culture/drug susceptibility testing flowchart for drug resistance survey in Tanzania
See this image and copyright information in PMC

References

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