Prevalence of drug resistant TB among outpatients at an HIV/TB clinic in Lilongwe, Malawi.

Prevalence of drug resistant TB among outpatients at an HIV/TB clinic in Lilongwe, Malawi.

Trans R Soc Trop Med Hyg. 2015 Dec;109(12):763-8

Authors: Barnett B, Gokhale RH, Krysiak R, Kanyemba C, Chikaonda T, Bokosi M, Mukuzunga C, Saidi F, Phiri S, Hoffman IF, Hosseinipour MC

Abstract
BACKGROUND: We sought to determine the prevalence of drug resistant TB among outpatients initiating TB treatment in Lilongwe, Malawi.
METHODS: This was a prospective cohort study of patients 18 years and older initiating TB treatment at Martin Preuss Centre, the primary integrated HIV/TB clinic in Lilongwe, Malawi, from April 2011 to July 2012. Procedures included questionnaires, physical exam, chest x-ray, full blood count and sputum collection. Sputum samples underwent acid-fast bacilli (AFB) smear testing and culture by Lowenstein-Jensen (LJ) and liquid Mycobacteria Growth Indicator Tube (MGIT) methods. Drug sensitivity was investigated using the Hain GenoType MTBDRplus line probe assay.
RESULTS: Of the 702 patients, 219 (31.2%) were female and 653 (93.0%) were presenting for first-time TB treatment. HIV co-infection was present in 420 (59.8%) cases, with 137 (32.6%) of those patients receiving antiretroviral therapy at presentation. TB was culture-confirmed in 375 (53.4%) patients, 349 of which were first time treatment and 26 retreatment. Ten cases of isoniazid-resistant TB (2.9% of culture confirmed cases of newly treated TB), one of rifampin-resistant TB (0.3% culture confirmed cases of newly treated TB) and one of multi-drug resistant TB (MDR-TB) (3.8% of culture confirmed cases of retreatment TB) were detected.
CONCLUSIONS: MDR-TB prevalence is low among outpatients initiating TB treatment in Lilongwe.

PMID: 26626340 [PubMed - in process]