TITLE:
Contribution to the Study of Resistance to Anti-Tuberculosis Drugs in the Mycobacterium tuberculosis Complex Isolated at the National Laboratory of Clinical Biology and Public Health in Bangui in the Central African Republic in 2022: Case of Rifampicin
AUTHORS:
Clotaire Donatien Rafaï, Max Namzeka, Ernest Lango-Yaya, Romaric Oscar Tibet Kada, Oscar Senzongo Ndimakamoko, Serge Henri Gbazi, Le Bon Bondom, Christian Maucler Pamatika, Boniface Koffi, Alain Le Faou
KEYWORDS:
GeneXpert, Resistance, Mycobacterium tuberculosis, Bangui
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.11 No.4,
December
26,
2023
ABSTRACT: Microscopy-positive and drug-resistant pulmonary
tuberculosis (MPT+) is one of the most feared diseases due to the cost of its
management and the associated mortality. The GeneXpert, a new molecular test,
is in greater demand for the diagnosis of MPT+ resistance cases. The
application of GeneXpert to new cases of MPT+ is not effective in the country’s TB screening centres.
The objective of this study is to assess the contribution of GeneXpert to the
determination of MPT+ resistance cases in Bangui. The study was cross-sectional
and covered the period from February to July 2022. The diagnosis of
tuberculosis was first performed by microscopy with Ziehl Neelsen hot stain.
The GeneXpert was then used to test for resistance in the sputum of all
patients with positive microscopy. The collected data was entered into Excel
2013 and analysed with Epi Info 3.3.7. We analysed data from 755 patients, 80
of whom had resistance. The 80 patients ranged in age from 6 to 68 years (mean
age = 35 years). The prevalence of resistant TB was 10.60% (80/755). Primary resistance accounted for 73.75% and
secondary resistance for 26.25%. The age group 20 - 39 years (57.50%),
male (72.50%), 8th district (17.50%), people living in couples (53.75%),
farmers (13.75%) were the socio-demographic
characteristics most affected by resistance. Treatment failure (13.75%),
relapses (13.75%), the notion of contagion (28.75%), a history of smoking (40%)
and alcohol (61.25%) were the clinical antecedents reported by the patients.
Treatment failure and relapse were the variables associated with the occurrence
of resistant PMT+ (p 0.05). A considerable proportion of the overall Mycobacterium tuberculosis resistance to anti-tuberculosis drugs
(10.60%) was identified by GeneXpert. Treatment failure and relapse were the
factors associated with the risk of resistance.