Epidemiology and genetic diversity of multidrug-resistant tuberculosis in East Africa

Tuberculosis (Edinb). 2014 Jan;94(1):1-7. doi: 10.1016/j.tube.2013.08.009. Epub 2013 Sep 7.


Multidrug-resistant tuberculosis (MDR-TB) is an emerging problem in many parts of the world, and levels of MDR-TB among new TB patients are increasing in sub-Saharan Africa. We reviewed the prevalence and molecular epidemiology of MDR-TB in East Africa, including Burundi, Kenya, Rwanda, Tanzania, and Uganda. In 16 epidemiologic surveys, the prevalence of MDR among new cases ranges from 0.4% in Tanzania to 4.4% in Uganda, and among recurrent cases ranges from 3.9% in Tanzania to 17.7% in Uganda. There is a gap of 5948 cases between the estimated number of MDR-TB cases in East Africa and the number actually diagnosed. The only confirmed risk factors for MDR-TB are prior treatment for TB and refugee status. HIV has not been reported as a risk factor, and there are no reports of statistical association between spoligotype and drug resistance pattern. Increased capacity for diagnosis and treatment of MDR-TB is needed, with an emphasis on recurrent TB cases and refugees.

Keywords: East Africa; Genetic diversity; Multidrug-resistant tuberculosis (MDR-TB); Prevalence; Risk factors.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Africa, Eastern / epidemiology
  • Antitubercular Agents / therapeutic use*
  • Genetic Variation*
  • Genotype
  • Humans
  • Molecular Epidemiology
  • Mutation
  • Mycobacterium tuberculosis / genetics*
  • Prevalence
  • Refugees / statistics & numerical data*
  • Risk Factors
  • Secondary Prevention
  • Sentinel Surveillance
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Tuberculosis, Multidrug-Resistant / genetics
  • Tuberculosis, Multidrug-Resistant / prevention & control


  • Antitubercular Agents