Tuberculosis drug resistance in Bamako, Mali, from 2006 to 2014

B. Diarra; D. Goita; S. Tounkara; M. Sanogo; B. Baya; A. C G Togo; M. Maiga; Y. S. Sarro; A. Kone; B. Kone; O. M'Baye; N. Coulibaly; H. Kassambara; A. Cisse; M. Belson; M. A. Polis; J. Otu; F. Gehre; M. Antonio; S. Dao; S. Siddiqui; R. L. Murphy; B. C. de Jong; S. Diallo

doi:10.1186/s12879-016-2060-7

Tuberculosis drug resistance in Bamako, Mali, from 2006 to 2014

B. Diarra^*, D. Goita, S. Tounkara, M. Sanogo, B. Baya, A. C G Togo, M. Maiga, Y. S. Sarro, A. Kone, B. Kone, O. M'Baye, N. Coulibaly, H. Kassambara, A. Cisse, M. Belson, M. A. Polis, J. Otu, F. Gehre, M. Antonio, S. DaoS. Siddiqui, R. L. Murphy, B. C. de Jong, S. Diallo

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

Background: Although Drug resistance tuberculosis is not a new phenomenon, Mali remains one of the "blank" countries without systematic data. Methods: Between 2006 and 2014, we enrolled pulmonary TB patients from local TB diagnostics centers and a university referral hospital in several observational cohort studies. These consecutive patients had first line drug susceptibility testing (DST) performed on their isolates. A subset of MDR was subsequently tested for second line drug resistance. Results: A total of 1186 mycobacterial cultures were performed on samples from 522 patients, including 1105 sputa and 81 blood samples, yielding one or more Mycobacterium tuberculosis complex (Mtbc) positive cultures for 343 patients. Phenotypic DST was performed on 337 (98.3%) unique Mtbc isolates, of which 127 (37.7%) were resistant to at least one drug, including 75 (22.3%) with multidrug resistance (MDR). The overall prevalence of MDR-TB was 3.4% among new patients and 66.3% among retreatment patients. Second line DST was available for 38 (50.7%) of MDR patients and seven (18.4%) had resistance to either fluoroquinolones or second-line injectable drugs. Conclusion: The drug resistance levels, including MDR, found in this study are relatively high, likely related to the selected referral population. While worrisome, the numbers remained stable over the study period. These findings prompt a nationwide drug resistance survey, as well as continuous surveillance of all retreatment patients, which will provide more accurate results on countrywide drug resistance rates and ensure that MDR patients access appropriate second line treatment.

Original language	English (US)
Article number	714
Journal	BMC Infectious Diseases
Volume	16
Issue number	1
DOIs	https://doi.org/10.1186/s12879-016-2060-7
State	Published - Nov 28 2016

Funding

This study was partially funded by the Northwestern University (Chicago, IL, USA) through ACTG U01AI069471, the University of Sciences, Techniques and Technologies of Bamako (USTTB) through NIH/R01 grant R01AI110386, the European & Developing Countries Clinical Trials Partnership (EDCTP) through the West African Node of Excellence for TB, AIDS and Malaria (WANETAM) Grants numbers CG_cb_07_41700 and MSI 2010_10800-01/08/2011-31/07/14 and the European Research Council-INTERRUPTB through grant nr.311725 (to B.d.J.). B.D. was supported by a TDR fellowship, TIMS ID B40072, the special programme for research and training in tropical diseases, co-sponsored by UNICEF, UNDP, World Bank and WHO.

Keywords

Bamako
Mali
Tuberculosis Drug resistance

ASJC Scopus subject areas

Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12879-016-2060-7

Cite this

Diarra, B., Goita, D., Tounkara, S., Sanogo, M., Baya, B., Togo, A. C. G., Maiga, M., Sarro, Y. S., Kone, A., Kone, B., M'Baye, O., Coulibaly, N., Kassambara, H., Cisse, A., Belson, M., Polis, M. A., Otu, J., Gehre, F., Antonio, M., ... Diallo, S. (2016). Tuberculosis drug resistance in Bamako, Mali, from 2006 to 2014. BMC Infectious Diseases, 16(1), Article 714. https://doi.org/10.1186/s12879-016-2060-7

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abstract = "Background: Although Drug resistance tuberculosis is not a new phenomenon, Mali remains one of the {"}blank{"} countries without systematic data. Methods: Between 2006 and 2014, we enrolled pulmonary TB patients from local TB diagnostics centers and a university referral hospital in several observational cohort studies. These consecutive patients had first line drug susceptibility testing (DST) performed on their isolates. A subset of MDR was subsequently tested for second line drug resistance. Results: A total of 1186 mycobacterial cultures were performed on samples from 522 patients, including 1105 sputa and 81 blood samples, yielding one or more Mycobacterium tuberculosis complex (Mtbc) positive cultures for 343 patients. Phenotypic DST was performed on 337 (98.3%) unique Mtbc isolates, of which 127 (37.7%) were resistant to at least one drug, including 75 (22.3%) with multidrug resistance (MDR). The overall prevalence of MDR-TB was 3.4% among new patients and 66.3% among retreatment patients. Second line DST was available for 38 (50.7%) of MDR patients and seven (18.4%) had resistance to either fluoroquinolones or second-line injectable drugs. Conclusion: The drug resistance levels, including MDR, found in this study are relatively high, likely related to the selected referral population. While worrisome, the numbers remained stable over the study period. These findings prompt a nationwide drug resistance survey, as well as continuous surveillance of all retreatment patients, which will provide more accurate results on countrywide drug resistance rates and ensure that MDR patients access appropriate second line treatment.",

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Diarra, B, Goita, D, Tounkara, S, Sanogo, M, Baya, B, Togo, ACG, Maiga, M, Sarro, YS, Kone, A, Kone, B, M'Baye, O, Coulibaly, N, Kassambara, H, Cisse, A, Belson, M, Polis, MA, Otu, J, Gehre, F, Antonio, M, Dao, S, Siddiqui, S, Murphy, RL, de Jong, BC & Diallo, S 2016, 'Tuberculosis drug resistance in Bamako, Mali, from 2006 to 2014', BMC Infectious Diseases, vol. 16, no. 1, 714. https://doi.org/10.1186/s12879-016-2060-7

TY - JOUR

T1 - Tuberculosis drug resistance in Bamako, Mali, from 2006 to 2014

AU - Diarra, B.

AU - Goita, D.

AU - Tounkara, S.

AU - Sanogo, M.

AU - Baya, B.

AU - Togo, A. C G

AU - Maiga, M.

AU - Sarro, Y. S.

AU - Kone, A.

AU - Kone, B.

AU - M'Baye, O.

AU - Coulibaly, N.

AU - Kassambara, H.

AU - Cisse, A.

AU - Belson, M.

AU - Polis, M. A.

AU - Otu, J.

AU - Gehre, F.

AU - Antonio, M.

AU - Dao, S.

AU - Siddiqui, S.

AU - Murphy, R. L.

AU - de Jong, B. C.

AU - Diallo, S.

PY - 2016/11/28

Y1 - 2016/11/28

N2 - Background: Although Drug resistance tuberculosis is not a new phenomenon, Mali remains one of the "blank" countries without systematic data. Methods: Between 2006 and 2014, we enrolled pulmonary TB patients from local TB diagnostics centers and a university referral hospital in several observational cohort studies. These consecutive patients had first line drug susceptibility testing (DST) performed on their isolates. A subset of MDR was subsequently tested for second line drug resistance. Results: A total of 1186 mycobacterial cultures were performed on samples from 522 patients, including 1105 sputa and 81 blood samples, yielding one or more Mycobacterium tuberculosis complex (Mtbc) positive cultures for 343 patients. Phenotypic DST was performed on 337 (98.3%) unique Mtbc isolates, of which 127 (37.7%) were resistant to at least one drug, including 75 (22.3%) with multidrug resistance (MDR). The overall prevalence of MDR-TB was 3.4% among new patients and 66.3% among retreatment patients. Second line DST was available for 38 (50.7%) of MDR patients and seven (18.4%) had resistance to either fluoroquinolones or second-line injectable drugs. Conclusion: The drug resistance levels, including MDR, found in this study are relatively high, likely related to the selected referral population. While worrisome, the numbers remained stable over the study period. These findings prompt a nationwide drug resistance survey, as well as continuous surveillance of all retreatment patients, which will provide more accurate results on countrywide drug resistance rates and ensure that MDR patients access appropriate second line treatment.

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KW - Tuberculosis Drug resistance

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Tuberculosis drug resistance in Bamako, Mali, from 2006 to 2014

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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