Clinical risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Mali

Bocar Baya*, Chad J. Achenbach, Bourahima Kone, Yacouba Toloba, Djeneba K. Dabitao, Bassirou Diarra, Drissa Goita, Seydou Diabaté, Mamoudou Maiga, Dianguina Soumare, Khadidia Ouattara, Tenin Kanoute, Gaoussou Berthe, Youssouf M. Kamia, Yeya dit Sadio Sarro, Moumine Sanogo, Antieme C.G. Togo, Bindongo P.P. Dembele, Nadie Coulibaly, Amadou KoneMaxwell Akanbi, Michael Belson, Sounkalo Dao, Susan Orsega, Sophia Siddiqui, Seydou Doumbia, Robert L. Murphy, Souleymane Diallo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background: MDR-TB is a major threat to global TB control. In 2015, 580,000 were treated for MDR-TB worldwide. The worldwide roll-out of GeneXpert MTB/RIF ® has improved diagnosis of MDR-TB; however, in many countries laboratories are unable to assess drug resistance and clinical predictors of MDR-TB could help target suspected patients. In this study, we aimed to determine the clinical factors associated with MDR-TB in Bamako, Mali. Methods: We performed a cross-sectional study of 214 patients with presumed MDR-TB admitted to University of Bamako Teaching Hospital, Point-G between 2007 and 2016. We calculated crude and adjusted odds ratios for MDR-TB disease diagnosis using SPSS. Results: We found that age ≤40 years (OR = 2.56. 95% CI: 1.44–4.55), two courses of prior TB treatment (OR = 3.25, 95% CI: 1.44–7.30), TB treatment failure (OR = 3.82, 95% CI 1.82–7.79), sputum microscopy with 3+ bacilli load (OR = 1.98, 95% CI: 1.13–3.48) and a history of contact with a TB patient (OR = 2.48, 95% CI: 1.11–5.50) were significantly associated with confirmation of MDR-TB disease. HIV was not a risk factor for MDR-TB (aOR = 0.88, 95% CI: 0.34–1.94). Conclusion: We identified several risk factors that could be used to identify MDR-TB suspects and prioritize them for laboratory confirmation. Prospective studies are needed to understand factors associated with TB incidence and clinical outcomes of TB treatment and disease.

Original languageEnglish (US)
Pages (from-to)149-155
Number of pages7
JournalInternational Journal of Infectious Diseases
Volume81
DOIs
StatePublished - Apr 2019

Keywords

  • Mali
  • Multi-Drug Resistant Tuberculosis
  • Risk factors

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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