Multi drug and other forms of drug resistant tuberculosis are uncommon among treatment naïve tuberculosis patients in Tanzania

Tumaini J Nagu; Said Aboud; Ramadhani Mwiru; Mecky Matee; Wafaie Fawzi; Ferdinand Mugusi

doi:10.1371/journal.pone.0118601

Multi drug and other forms of drug resistant tuberculosis are uncommon among treatment naïve tuberculosis patients in Tanzania

PLoS One. 2015 Apr 7;10(4):e0118601. doi: 10.1371/journal.pone.0118601. eCollection 2015.

Authors

Tumaini J Nagu¹, Said Aboud², Ramadhani Mwiru³, Mecky Matee², Wafaie Fawzi⁴, Ferdinand Mugusi⁵

Affiliations

¹ Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
² Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
³ Management and Development for Health, Dar es Salaam, Tanzania.
⁴ Department of Global Health and Population, Harvard School of Public Health (HSPH), Boston, Massachusetts, United States of America.
⁵ Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Abstract

Background: Surveillance and effective management of drug resistance is important to sustaining tuberculosis (TB) control efforts. We aimed to determine resistance rates to first line anti tuberculosis drugs and to describe factors associated with the resistance to any of the first line anti tuberculosis drugs in Dar es Salaam Tanzania.

Materials: Newly diagnosed, TB patients with neither history of tuberculosis treatment nor isoniazid prophylaxis were included into the study. Sputum specimens were cultured on either mycobacteria growth indicator tube 960 (MGIT 960) or Lowenstein Jenstein (LJ) medium supplemented with either glycerol (GLJ) or pyruvate (PLJ). Drug susceptibility for isoniazid, rifampicin, streptomycin and ethambutol was determined by either Lowenstein-Jensen (LJ) medium or mycobacteria growth indicator tube 960 (MGIT 960).

Results: A total of 933 newly diagnosed TB patients, were included into the study. Multi drug resistance (MDR) tuberculosis was detected among 2 (0.2%) patients. Resistance to any of the four tested drugs was detected among 54 (5.8%) patients. Mono-resistance to isoniazid, rifampicin, streptomycin and ethambutol were 21(2.3%), 3 (0.3%), 13 (1.4%), 9 (1.0%) respectively.

Conclusion: Primary resistance to first line anti tuberculosis drugs is still low in this setting. Continued vigilance including periodic national surveillance of anti-tuberculosis resistance is recommended.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Antitubercular Agents / therapeutic use
Cross-Sectional Studies
Female
Humans
Isoniazid / therapeutic use
Male
Microbial Sensitivity Tests
Middle Aged
Mycobacterium tuberculosis / drug effects
Mycobacterium tuberculosis / pathogenicity*
Prospective Studies
Tanzania / epidemiology
Tuberculosis, Multidrug-Resistant / drug therapy
Tuberculosis, Multidrug-Resistant / epidemiology*
Tuberculosis, Multidrug-Resistant / microbiology
Tuberculosis, Pulmonary / drug therapy
Tuberculosis, Pulmonary / epidemiology*
Tuberculosis, Pulmonary / microbiology
Young Adult

Substances

Antitubercular Agents
Isoniazid

Grants and funding

This study was funded by the global health scholarship program for junior scientists and Swedish International Development Agency (SIDA). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.