The burden of drug resistance tuberculosis in Ghana; results of the First National Survey.
Resistance to Tuberculosis drugs has become a major threat to the control of tuberculosis (TB) globally. We conducted the first nation-wide drug resistance survey to investigate the level and pattern of resistance to first-line TB drugs among newly and previously treated sputum smear-positive TB cas...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/54c3859089d740e59861d16c32aa310a |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:54c3859089d740e59861d16c32aa310a |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:54c3859089d740e59861d16c32aa310a2021-12-02T20:07:10ZThe burden of drug resistance tuberculosis in Ghana; results of the First National Survey.1932-620310.1371/journal.pone.0252819https://doaj.org/article/54c3859089d740e59861d16c32aa310a2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252819https://doaj.org/toc/1932-6203Resistance to Tuberculosis drugs has become a major threat to the control of tuberculosis (TB) globally. We conducted the first nation-wide drug resistance survey to investigate the level and pattern of resistance to first-line TB drugs among newly and previously treated sputum smear-positive TB cases. We also evaluated associations between potential risk factors and TB drug resistance. Using the World Health Organization (WHO) guidelines on conducting national TB surveys, we selected study participants from 33 health facilities from across the country, grouped into 29 clusters, and included them into the survey. Between April 2016 and June 2017, a total of 927 patients (859 new and 68 previously treated) were enrolled in the survey. Mycobacterium tuberculosis complex (MTBC) isolates were successfully cultured from 598 (65.5%) patient samples and underwent DST, 550 from newly diagnosed and 48 from previously treated patients. The proportion of patients who showed resistance to any of the TB drugs tested was 25.2% (95% CI; 21.8-28.9). The most frequent resistance was to Streptomycin (STR) (12.3%), followed by Isoniazid (INH) (10.4%), with Rifampicin (RIF), showing the least resistance of 2.4%. Resistance to Isoniazid and Rifampicin (multi-drug resistance) was found in 19 (3.2%; 95% CI: 1.9-4.9) isolates. Prevalence of multidrug resistance was 7 (1.3%; 95% CI: 0.5-2.6) among newly diagnosed and 12 (25.0%; 95% CI: 13.6-39.6) among previously treated patients. At both univariate and multivariate analysis, MDR-TB was positively associated with previous history of TB treatment (OR = 5.09, 95% CI: 1.75-14.75, p = 0.003); (OR = 5.41, 95% CI: 1.69-17.30, p = 0.004). The higher levels of MDR-TB and overall resistance to any TB drug among previously treated patients raises concerns about adherence to treatment. This calls for strengthening existing TB programme measures to ensure a system for adequately testing and monitoring TB drug resistance.Augustina Angelina SylverkenAlexander KwartengSampson Twumasi-AnkrahMichael OwusuRejoice Agyeiwaa ArthurRexford Mawunyo DumeviLouis Adu-AmoahNicholas AddofohPortia Boakye OkyereFrancisca DzataFrank BonsuYaw Adusi-PokuKatharina KranzerAndrew SirokaWayne van GemertAnna DeanEllis Owusu-DaboPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252819 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Augustina Angelina Sylverken Alexander Kwarteng Sampson Twumasi-Ankrah Michael Owusu Rejoice Agyeiwaa Arthur Rexford Mawunyo Dumevi Louis Adu-Amoah Nicholas Addofoh Portia Boakye Okyere Francisca Dzata Frank Bonsu Yaw Adusi-Poku Katharina Kranzer Andrew Siroka Wayne van Gemert Anna Dean Ellis Owusu-Dabo The burden of drug resistance tuberculosis in Ghana; results of the First National Survey. |
| description |
Resistance to Tuberculosis drugs has become a major threat to the control of tuberculosis (TB) globally. We conducted the first nation-wide drug resistance survey to investigate the level and pattern of resistance to first-line TB drugs among newly and previously treated sputum smear-positive TB cases. We also evaluated associations between potential risk factors and TB drug resistance. Using the World Health Organization (WHO) guidelines on conducting national TB surveys, we selected study participants from 33 health facilities from across the country, grouped into 29 clusters, and included them into the survey. Between April 2016 and June 2017, a total of 927 patients (859 new and 68 previously treated) were enrolled in the survey. Mycobacterium tuberculosis complex (MTBC) isolates were successfully cultured from 598 (65.5%) patient samples and underwent DST, 550 from newly diagnosed and 48 from previously treated patients. The proportion of patients who showed resistance to any of the TB drugs tested was 25.2% (95% CI; 21.8-28.9). The most frequent resistance was to Streptomycin (STR) (12.3%), followed by Isoniazid (INH) (10.4%), with Rifampicin (RIF), showing the least resistance of 2.4%. Resistance to Isoniazid and Rifampicin (multi-drug resistance) was found in 19 (3.2%; 95% CI: 1.9-4.9) isolates. Prevalence of multidrug resistance was 7 (1.3%; 95% CI: 0.5-2.6) among newly diagnosed and 12 (25.0%; 95% CI: 13.6-39.6) among previously treated patients. At both univariate and multivariate analysis, MDR-TB was positively associated with previous history of TB treatment (OR = 5.09, 95% CI: 1.75-14.75, p = 0.003); (OR = 5.41, 95% CI: 1.69-17.30, p = 0.004). The higher levels of MDR-TB and overall resistance to any TB drug among previously treated patients raises concerns about adherence to treatment. This calls for strengthening existing TB programme measures to ensure a system for adequately testing and monitoring TB drug resistance. |
| format |
article |
| author |
Augustina Angelina Sylverken Alexander Kwarteng Sampson Twumasi-Ankrah Michael Owusu Rejoice Agyeiwaa Arthur Rexford Mawunyo Dumevi Louis Adu-Amoah Nicholas Addofoh Portia Boakye Okyere Francisca Dzata Frank Bonsu Yaw Adusi-Poku Katharina Kranzer Andrew Siroka Wayne van Gemert Anna Dean Ellis Owusu-Dabo |
| author_facet |
Augustina Angelina Sylverken Alexander Kwarteng Sampson Twumasi-Ankrah Michael Owusu Rejoice Agyeiwaa Arthur Rexford Mawunyo Dumevi Louis Adu-Amoah Nicholas Addofoh Portia Boakye Okyere Francisca Dzata Frank Bonsu Yaw Adusi-Poku Katharina Kranzer Andrew Siroka Wayne van Gemert Anna Dean Ellis Owusu-Dabo |
| author_sort |
Augustina Angelina Sylverken |
| title |
The burden of drug resistance tuberculosis in Ghana; results of the First National Survey. |
| title_short |
The burden of drug resistance tuberculosis in Ghana; results of the First National Survey. |
| title_full |
The burden of drug resistance tuberculosis in Ghana; results of the First National Survey. |
| title_fullStr |
The burden of drug resistance tuberculosis in Ghana; results of the First National Survey. |
| title_full_unstemmed |
The burden of drug resistance tuberculosis in Ghana; results of the First National Survey. |
| title_sort |
burden of drug resistance tuberculosis in ghana; results of the first national survey. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/54c3859089d740e59861d16c32aa310a |
| work_keys_str_mv |
AT augustinaangelinasylverken theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT alexanderkwarteng theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT sampsontwumasiankrah theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT michaelowusu theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT rejoiceagyeiwaaarthur theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT rexfordmawunyodumevi theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT louisaduamoah theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT nicholasaddofoh theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT portiaboakyeokyere theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT franciscadzata theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT frankbonsu theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT yawadusipoku theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT katharinakranzer theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT andrewsiroka theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT waynevangemert theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT annadean theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT ellisowusudabo theburdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT augustinaangelinasylverken burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT alexanderkwarteng burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT sampsontwumasiankrah burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT michaelowusu burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT rejoiceagyeiwaaarthur burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT rexfordmawunyodumevi burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT louisaduamoah burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT nicholasaddofoh burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT portiaboakyeokyere burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT franciscadzata burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT frankbonsu burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT yawadusipoku burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT katharinakranzer burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT andrewsiroka burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT waynevangemert burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT annadean burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey AT ellisowusudabo burdenofdrugresistancetuberculosisinghanaresultsofthefirstnationalsurvey |
| _version_ |
1718375302435962880 |