Multidrug-resistant tuberculosis among previously treated patients in the Philippines

OBJECTIVE: To determine the drug resistance profile of Mycobacterium tuberculosis in Mozambique. METHODS: We analyzed secondary data from the National Tuberculosis Referral Laboratory, in the city of Maputo, Mozambique, and from the Beira Regional Tuberculosis Referral Laboratory, in the city of Beira, Mozambique. The data were based on culture-positive samples submitted to first-line drug susceptibility testing (DST) between January and December of 2011. We attempted to determine whether the frequency of DST positivity was associated with patient type or provenance. RESULTS: During the study period, 641 strains were isolated in culture and submitted to DST. We found that 374 (58.3%) were resistant to at least one antituberculosis drug and 280 (43.7%) were resistant to multiple antituberculosis drugs. Of the 280 multidrug-resistant tuberculosis cases, 184 (65.7%) were in previously treated patients, most of whom were from southern Mozambique. Two (0.71%) of the cases of multidrug-resistant tuberculosis were confirmed to be cases of extensively drug-resistant tuberculosis. Multidrug-resistant tuberculosis was most common in males, particularly those in the 21-40 year age bracket. CONCLUSIONS: M. tuberculosis resistance to antituberculosis drugs is high in Mozambique, especially in previously treated patients. The frequency of M. tuberculosis strains that were resistant to isoniazid, rifampin, and streptomycin in combination was found to be high, particularly in samples from previously treated patients.

Download Full-text

DOTS-Plus for multidrug-resistant tuberculosis in the Philippines: global assistance urgently needed

Tuberculosis ◽

10.1016/s1472-9792(02)00072-0 ◽

2003 ◽

Vol 83 (1-3) ◽

pp. 52-58 ◽

Cited By ~ 10

Author(s):

T.E. Tupasi ◽

M.I.D. Quelapio ◽

R.B. Orillaza ◽

C. Alcantara ◽

N.R.C. Mira ◽

...

Keyword(s):

Multidrug Resistant ◽

The Philippines ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis

Download Full-text

Screening outcomes from patients with suspected multidrug-resistant tuberculosis: lessons learned in the Philippines

The International Journal of Tuberculosis and Lung Disease ◽

10.5588/ijtld.12.0038 ◽

2012 ◽

Vol 16 (10) ◽

pp. 1326-1330 ◽

Cited By ~ 5

Author(s):

M. T. Gler ◽

R. S. Guilatco ◽

C. V. Guray ◽

T. E. Tupasi

Keyword(s):

Multidrug Resistant ◽

The Philippines ◽

Lessons Learned ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis

Download Full-text

Primary Clofazimine and Bedaquiline Resistance among Isolates from Patients with Multidrug-Resistant Tuberculosis

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00239-17 ◽

2017 ◽

Vol 61 (6) ◽

Cited By ~ 47

Author(s):

Jian Xu ◽

Bin Wang ◽

Minghao Hu ◽

Fengmin Huo ◽

Shaochen Guo ◽

...

Keyword(s):

Multidrug Resistant ◽

Cross Resistance ◽

Drug Resistant ◽

Content Type ◽

Tb Treatment ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Mdr Tb ◽

Previously Treated ◽

Alamarblue Assay

ABSTRACT Clofazimine has been repurposed for the treatment of tuberculosis, especially for multidrug-resistant tuberculosis (MDR-TB). To test the susceptibility to clofazimine of Mycobacterium tuberculosis clinical isolates, MICs of clofazimine were determined using the microplate alamarBlue assay (MABA) method for 80 drug-resistant isolates and 10 drug-susceptible isolates for comparison. For five clofazimine-resistant strains isolated from previously treated pre-extensively drug-resistant TB (pre-XDR-TB) and XDR-TB patients without prior exposure to clofazimine or bedaquiline, clofazimine MICs were ≥1.2 μg/ml. Four isolates with cross-resistance to bedaquiline had Rv0678 mutations. The other isolate with no resistance to bedaquiline had an Rv1979c mutation. This study adds to a recent study showing that 6.3% of MDR-TB patients without prior clofazimine or bedaquiline exposure harbored isolates with Rv0678 mutations, which raises concern that preexisting resistance to these drugs may be associated with prior TB treatment. Furthermore, we propose a tentative breakpoint of 1.2 μg/ml for clofazimine resistance using the MABA method. More-widespread surveillance and individualized testing for clofazimine and bedaquiline resistance, together with assessment of their clinical usage, especially among previously treated and MDR-TB patients, are warranted.

Download Full-text

Prevalence of tuberculosis in silicosis patients in southern part of Rajasthan

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20205458 ◽

2020 ◽

Vol 9 (1) ◽

pp. 68

Author(s):

Atul Luhadia ◽

Shanti Kumar Luhadia ◽

Rahul Ahluwalia ◽

Kamal Preet Singh Arora ◽

Rahul Kumar ◽

...

Keyword(s):

Multidrug Resistant ◽

Educational Programme ◽

Occupational Lung Disease ◽

Mining Areas ◽

Silica Dust ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Prophylactic Measures ◽

Microbiological Examination ◽

Previously Treated

Background: Silicosis is an occupational lung disease which commonly occurs in workers involved in quarrying, mining, sandblasting etc. Tuberculosis (TB) in silicosis is more common. In southern part of Rajasthan, near Udaipur a lot of mining areas are there and workers are exposed to silica dust. The main objective of carrying out this study is to bring in focus the increasing prevalence of silicosis patients and its complications in mining areas around Udaipur in southern Rajasthan, so that the necessary prophylactic and preventive measures can be taken for the workers in future.Methods: 150 patients of silicosis and old treated case of silicotuberculosis patient with respiratory symptoms were included in the study. In all the patients, sputum was sent for routine acid fast bacilli (AFB) smear examination and if it came negative then sputum was sent for GeneXpert multidrug resistant tuberculosis (MTB) and also for AFB culture examination wherever needed.Results: The mean duration of exposure to silica particles was 10 years (5 to 15 years). Tuberculosis was diagnosed by microbiological examination in 40 cases, while 25 cases which were previously treated for tuberculosis were found negative on microbiological examination. So, the overall prevalence of TB (both old treated and new or relapse microbiologically confirmed cases) among patients of silicosis was found to be 44%.Conclusions: Our study showed an increased prevalence of tuberculosis in silicosis patients. So, there should be regular health check up educational programme for all silica mines workers and all should use prophylactic measures.

Download Full-text

Performance of Multidrug-Resistant Tuberculosis Surveillance in Yemen: Interview Study (Preprint)

10.2196/preprints.14294 ◽

2019 ◽

Author(s):

Jihan Abdulmughni ◽

Esam Mohammed Mahyoub ◽

Abdulaziz Thabit Alaghbari ◽

Abdulwahed Abdelgabar Al Serouri ◽

Yousef Khader

Keyword(s):

Surveillance System ◽

Multidrug Resistant ◽

Sentinel Surveillance ◽

Surveillance Systems ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Mdr Tb ◽

Previously Treated ◽

Overall Performance ◽

The Government

BACKGROUND Multidrug-resistant tuberculosis (MDR-TB) is a major challenge to ending TB occurrence by 2035. In Yemen, the 2011 survey showed an MDR-TB prevalence of 1.4% among new cases and 14.4% among previously treated cases. The National Tuberculosis Control Program (NTCP) established four MDR-TB sentinel surveillance sites in 2013 to monitor the MDR-TB situation. In Yemen, the 2011 survey showed an MDR-TB prevalence of 1.4% among new cases and 14.4% among previously treated cases. The NTCP established four MDR-TB sentinel surveillance sites in 2013 to monitor the MDR-TB situation. OBJECTIVE This study aimed to assess the performance of MDR-TB surveillance and determine its strengths and weaknesses. METHODS We used the updated Center for Diseases Control and Prevention guidelines for evaluating public health surveillance systems. Interviews were conducted with NTCP managers and Regional MDR-TB centers’ staff using a semistructured questionnaire. We used a 5-point Likert scale to assess the usefulness and other attributes (eg, simplicity and flexibility). The mean percentage was calculated for each attribute and used for the final rank of the performance: poor (<60%), average (60%-80%), and good (>80%). RESULTS The MDR-TB surveillance system achieved good performance in usefulness (87%), acceptability (82%), and data quality (91%); average performance in flexibility (61%) and simplicity (72%); and poor performance in stability (55%). The overall performance score was average (74%). Although strong commitment, good monitoring, and well-trained staff are the main strengths, depending on an external fund is a major weakness along with unavailability of the MDR-TB unit at the governorate level. CONCLUSIONS Although the MDR-TB surveillance system has achieved an average overall performance, more efforts are required to improve its stability by ensuring constant power supply to enable laboratories to perform necessary diagnostic and follow-up tests. Gradual replacement of donors’ funds by the government is recommended. Scaling up of MDR-TB services and removing access barriers are crucial.

Download Full-text

Development of Multidrug Resistant Tuberculosis Among Patients Treated With Category II Regimen: A Lung Center of the Philippines Experience

CHEST Journal ◽

10.1378/chest.1360465 ◽

2012 ◽

Vol 142 (4) ◽

pp. 206A

Author(s):

Augusto Sablan ◽

Joven Gonong ◽

Lawrence Raymond ◽

Vivian Lofranco

Keyword(s):

Multidrug Resistant ◽

The Philippines ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis

Download Full-text

Performance of Multidrug-Resistant Tuberculosis Surveillance in Yemen: Interview Study

JMIR Public Health and Surveillance ◽

10.2196/14294 ◽

2019 ◽

Vol 5 (4) ◽

pp. e14294

Author(s):

Jihan Abdulmughni ◽

Esam Mohammed Mahyoub ◽

Abdulaziz Thabit Alaghbari ◽

Abdulwahed Abdelgabar Al Serouri ◽

Yousef Khader

Keyword(s):

Surveillance System ◽

Multidrug Resistant ◽

Sentinel Surveillance ◽

Surveillance Systems ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Mdr Tb ◽

Previously Treated ◽

Overall Performance ◽

The Government

Background Multidrug-resistant tuberculosis (MDR-TB) is a major challenge to ending TB occurrence by 2035. In Yemen, the 2011 survey showed an MDR-TB prevalence of 1.4% among new cases and 14.4% among previously treated cases. The National Tuberculosis Control Program (NTCP) established four MDR-TB sentinel surveillance sites in 2013 to monitor the MDR-TB situation. In Yemen, the 2011 survey showed an MDR-TB prevalence of 1.4% among new cases and 14.4% among previously treated cases. The NTCP established four MDR-TB sentinel surveillance sites in 2013 to monitor the MDR-TB situation. Objective This study aimed to assess the performance of MDR-TB surveillance and determine its strengths and weaknesses. Methods We used the updated Center for Diseases Control and Prevention guidelines for evaluating public health surveillance systems. Interviews were conducted with NTCP managers and Regional MDR-TB centers’ staff using a semistructured questionnaire. We used a 5-point Likert scale to assess the usefulness and other attributes (eg, simplicity and flexibility). The mean percentage was calculated for each attribute and used for the final rank of the performance: poor (<60%), average (60%-80%), and good (>80%). Results The MDR-TB surveillance system achieved good performance in usefulness (87%), acceptability (82%), and data quality (91%); average performance in flexibility (61%) and simplicity (72%); and poor performance in stability (55%). The overall performance score was average (74%). Although strong commitment, good monitoring, and well-trained staff are the main strengths, depending on an external fund is a major weakness along with unavailability of the MDR-TB unit at the governorate level. Conclusions Although the MDR-TB surveillance system has achieved an average overall performance, more efforts are required to improve its stability by ensuring constant power supply to enable laboratories to perform necessary diagnostic and follow-up tests. Gradual replacement of donors’ funds by the government is recommended. Scaling up of MDR-TB services and removing access barriers are crucial.

Download Full-text