Volume 14, Number 9—September 2008
Perspective
Underreported Threat of Multidrug-Resistant Tuberculosis in Africa
Yanis Ben Amor
, Bennett Nemser, Angad Singh, Alyssa Sankin, and Neil Schluger
, Bennett Nemser, Angad Singh, Alyssa Sankin, and Neil Schluger
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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