Volume 14, Number 9—September 2008
Perspective
Underreported Threat of Multidrug-Resistant Tuberculosis in Africa
Table 1
Prevalence of MDR TB among combined TB cases by country, Africa*
Country | MDR resistance value, % (95% CI) | Nationwide study | Year | Reference | References for other convenience sample surveys |
---|---|---|---|---|---|
Algeria | 1.4† (0.5–2.7) | NA | NA | (11) | |
Angola | 2.1† (0.6–8.9) | NA | NA | (11) | |
Benin | 1.0† (0.2–3.9) | NA | NA | (11) | |
Botswana | 1.6‡ (0.8–1.9) | Countrywide survey | 2002 | (1) | (17,18) |
Burkina Faso | 2.6† (8.8–11.0) | NA | NA | (11) | (19) |
Burundi | 1.4§ | Bujumbura survey | 2006 | (20) | |
Cameroon | 2.0† (0.6–8.9) | NA | NA | (11) | (12,13) |
Central African Republic | 2.2¶ (1.0–3.4) | Countryside survey | 1998 | (1) | (21) |
Chad | 1.9† (0.5–9.0) | NA | (11) | (22) | |
Congo, Brazzaville | 1.8† (0.5–8.2) | NA | NA | (11) | |
Côte d’Ivoire | 5.4† (3.2–8.4) | NA | NA | (11) | (23) |
Democratic Republic of Congo | 5.8¶ (0.6–10.3) | Kinshasa survey | 1999 | (1) | |
Equatorial Guinea | 3.4§ | 5 of 18 survey districts | 2004 | (24) | |
Eritrea | 1.9† (0.5–9.0) | NA | NA | (11) | |
Ethiopia | 2.5¶ | Countrywide survey | 2005 | (1) | (25–27) |
Gabon | 1.8† (0.6–8.1) | NA | NA | (11) | |
Gambia | 0.4¶ (0.0–1.4) | Countrywide survey | 2000 | (28) | |
Ghana | 1.9† (0.5–8.7) | NA | NA | (11) | |
Guinea | 2.1¶ (1.0–3.0) | Sentinel sites survey | 1998 | (1) | |
Guinea-Bissau | 2.6† (0.8–1.4) | NA | NA | (11) | |
Kenya | 0¶ (0.0–1.1) | Nearly countrywide survey | 1995 | (1) | (29–31) |
Lesotho | 1.6¶ (0.4–2.6) | Countrywide survey | 1995 | (1) | |
Madagascar | 0.7¶ (0.7–10.3) | Countrywide survey | 2007 | (1) | (14) |
Malawi | 1.9† (0.5–9.3) | NA | NA | (11) | (15,16) |
Mali | 1.5† (0.3–7.9) | NA | NA | (11) | |
Mauritius | 1.4† (0.4–6.4) | NA | NA | (11) | |
Mozambique | 3.5¶ (2.5–4.6) | Countrywide survey | 1999 | (1) | (32,33) |
Namibia | 1.5† (0.4–7.1) | NA | NA | (11) | |
Niger | 2.7† (0.8–11.5) | NA | NA | (11) | |
Nigeria | 2.0† (0.6–9.3) | NA | NA | (11) | |
Rwanda | 4.6 | Countrywide survey | 2005 | (34) | |
Senegal | 4.3¶ (0.8–10.6) | Countrywide survey | 2006 | (1) | |
Sierra Leone | 3.1¶ (0.3–4.0) | Nearly countrywide survey | 1997 | (1) | |
South Africa | 3.1¶ (2.2–3.0) | Countrywide survey | 2002 | (1) | (2,35–39) |
Swaziland | 1.9¶ (0.5–3.1) | Countrywide survey | 1995 | (1) | |
Togo | 2.1† (0.6–9.5) | NA | NA | (11) | |
Uganda | 1¶ (0.1–1.6) | 3 district surveys | 1997 | (1) | |
Tanzania | 1¶ (0.6–9.8) | Countrywide survey | 2007 | (1) | |
Zambia | 1.8¶ (0.8–3.1) | Countrywide survey | 2000 | (1) | |
Zimbabwe | 2.2¶ (1.3–4.0) | Nearly countrywide survey | 1995 | (1) |
*TB, tuberculosis; MDR TB, multidrug-resistant TB; CI, confidence interval; NA, not available.
†Formulaic.
‡National Drug Resistance survey.
§Convenience sample survey.
¶World Health Organization.
References
- World Health Organization. Anti-tuberculosis drug resistance in the world. Geneva: The Organization; 1997.
- World Health Organization. Global tuberculosis control: surveillance, planning, financing. Geneva: The Organization; 2007.
- Burman W, Benator D, Vernon A, Khan A, Jones B, Silva C, Acquired rifamycin resistance with twice-weekly treatment of HIV-related tuberculosis. Am J Respir Crit Care Med. 2006;173:350–6. DOIPubMedGoogle Scholar
- Li J, Munsiff SS, Driver CR, Sackoff J. Relapse and acquired rifampin resistance in HIV-infected patients with tuberculosis treated with rifampin- or rifabutin-based regimens in New York City, 1997–2000. Clin Infect Dis. 2005;41:83–91. DOIPubMedGoogle Scholar
- LoBue PA, Moser KS. Isoniazid- and rifampin-resistant tuberculosis in San Diego County, California, United States, 1993–2002. Int J Tuberc Lung Dis. 2005;9:501–6.PubMedGoogle Scholar
- Nettles RE, Mazo D, Alwood K, Gachuhi R, Maltas G, Wendel K, Risk factors for relapse and acquired rifamycin resistance after directly observed tuberculosis treatment: a comparison by HIV serostatus and rifamycin use. Clin Infect Dis. 2004;38:731–6. DOIPubMedGoogle Scholar
- Sandman L, Schluger NW, Davidow AL, Bonk S. Risk factors for rifampin-monoresistant tuberculosis: a case-control study. Am J Respir Crit Care Med. 1999;159:468–72.PubMedGoogle Scholar
- Vanacore P, Koehler B, Carbonara S, Zacchini F, Bassetti D, Antonucci G, Drug-resistant tuberculosis in HIV-infected persons: Italy 1999–2000. Infection. 2004;32:328–32. DOIPubMedGoogle Scholar
- Bruchfeld J, Aderaye G, Palme IB, Bjorvatn B, Ghebremichael S, Hoffner S, Molecular epidemiology and drug resistance of Mycobacterium tuberculosis isolates from Ethiopian pulmonary tuberculosis patients with and without human immunodeficiency virus infection. J Clin Microbiol. 2002;40:1636–43. DOIPubMedGoogle Scholar
- Githui WA, Jordaan AM, Juma ES, Kinyanjui P, Karimi FG, Kimwomi J, Identification of MDR-TB Beijing/W and other Mycobacterium tuberculosis genotypes in Nairobi, Kenya. Int J Tuberc Lung Dis. 2004;8:352–60.PubMedGoogle Scholar
- Holtz TH, Lancaster J, Laserson KF, Wells CD, Thorpe L, Weyer K. Risk factors associated with default from multidrug-resistant tuberculosis treatment, South Africa, 1999–2001. Int J Tuberc Lung Dis. 2006;10:649–55.PubMedGoogle Scholar
- Naidoo S, Jinabhai CC. TB in health care workers in KwaZulu-Natal, South Africa. Int J Tuberc Lung Dis. 2006;10:676–82.PubMedGoogle Scholar
- Patel VB, Padayatchi N, Bhigjee AI, Allen J, Bhagwan B, Moodley AA, Multidrug-resistant tuberculous meningitis in KwaZulu-Natal, South Africa. Clin Infect Dis. 2004;38:851–6. DOIPubMedGoogle Scholar
- World Health Organization. Anti-tuberculosis resistance in the world. Report no. 3. Geneva: The Organization; 2004.
- Espinal MA, Dye C. Can DOTS control multidrug-resistant tuberculosis? Lancet. 2005;365:1206–9. DOIPubMedGoogle Scholar
Page created: July 13, 2010
Page updated: July 13, 2010
Page reviewed: July 13, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.