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Volume 14, Number 9—September 2008

Perspective

Underreported Threat of Multidrug-Resistant Tuberculosis in Africa

Yanis Ben AmorComments to Author , Bennett Nemser, Angad Singh, Alyssa Sankin, and Neil Schluger
Author affiliations: Columbia University, New York, New York, USA;

Main Article

Table 2

Descriptive statistics for country-specific MDR rates and other TB-related factors, Africa*

Factor Average, presurvey years 
(1995 to survey year)
Average, postsurvey years 
(year after survey to 2005)
Wilcoxon signed rank test†
No., mean, median Range SD No., mean, median Range SD Z-score, p value‡
MDR rates 39, 2.21, 1.9 0.0–5.8 1.2
Incidence rate/100,000/ y 39, 116, 109 22–228 40.6 33, 152, 150 25–308 70.2 –3.92, 0.0001§
Case detection rate (new ss+)
39, 47.2, 49.8
8.2–86.0
22.4

32, 55.5, 56.2
13.6–112.2
27.5

–1.52, 0.130
Treatment indicators
Cured 36, 50.9, 52.3 17.1–74.6 14.2 32, 56.2, 59.0 16.6–78.4 14.5 –3.58, 0.0001§
Completed 39, 14.3, 12.4 3.1–47.4 9.8 32, 13.9, 11.1 1.3–38.5 8.9 1.27, 0.206
Died 36, 6.7, 6.1 2.6–19.5 3.3 32, 7.4, 7.2 0.7–17.1 3.5 –0.36, 0.721
Failed 36, 1.8, 1.6 0.0–7.8 1.5 32, 1.7, 1.3 0.2–5.3 1.2 –0.34, 0.738
Defaulted 36, 14.1, 13.2 4.4–41.4 6.8 32, 11.9, 10.9 2.6–39.7 7.4 2.48, 0.013§
Succeeded
36, 65.2, 67.0
33.0–83.5
10.3

32, 70.0, 70.5
37.1–90.3
10.3

–3.56, 0.0001§
Retreatment indicators
Cured 35, 47.1, 48.0 11.1–71.3 16.2 29, 48.5, 52.0 2.9–72.4 17.3 –1.22, 0.221
Completed 35, 14.1, 12.7 0.0–46.6 8.7 29, 13.4, 9.8 0.5–40.8 10.0 1.49, 0.135
Died 35, 7.9, 7.7 0.0–22.7 4.1 29, 10.4, 10.1 1.6–21.4 4.5 –2.27, 0.023§
Failed 35, 3.6, 2.8 0.2–14.6 2.8 29, 3.2, 3.0 –8.9 2.2 0.18, 0.861
Defaulted 35, 14.6, 12.8 4.6–29.3 6.9 29, 11.9, 10.9 2.7–26.7 6.2 1.49, 0.135
Succeeded
35, 61.1, 62.6
30.3–81.3
13.1

29, 61.9, 64.6
23.1–81.8
14.2

0.18, 0.861
Year 2005 only variables
Prevalence/100,000 38, 497, 513 55–936 178
TB mortality rate/100,000/ y 39, 79, 73 2–304 48
HIV/TB co-infection, % 39, 26.8, 19.0 0.5–75.0 20.5
Male/female ratio: case 
 notifications 36, 1.5, 1.5 0.7–2.6 0.4
Health expenditures (US $ per
 capita) 39, 107, 51 15–689 131

*MDR, multidrug resistance; TB, tuberculosis, SD, standard deviation; ss+, sputum sample positive.
†Based on presurvey minus postsurvey values. A negative Z-score is indicative of an increase over time.
‡Marginally statistically significant trend (p<0.10).
§Statistically significant trend (p<0.05).

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