Contribution to the Study of Resistance to Anti-Tuberculosis Drugs in the Mycobacterium tuberculosis Complex Isolated at the National Laboratory of Clinical Biology and Public Health in Bangui in the Central African Republic in 2022: Case of Rifampicin
Microscopy-positive and drug-resistant pulmonary
tuberculosis (MPT+) is one of the most feared diseases due to the cost of its
management and the associated mortality. The GeneXpert, a new molecular test,
is in greater demand for the diagnosis of MPT+ resistance cases. The
application of GeneXpert to new cases of MPT+ is not effective in the country’s TB screening centres.
The objective of this study is to assess the contribution of GeneXpert to the
determination of MPT+ resistance cases in Bangui. The study was cross-sectional
and covered the period from February to July 2022. The diagnosis of
tuberculosis was first performed by microscopy with Ziehl Neelsen hot stain.
The GeneXpert was then used to test for resistance in the sputum of all
patients with positive microscopy. The collected data was entered into Excel
2013 and analysed with Epi Info 3.3.7. We analysed data from 755 patients, 80
of whom had resistance. The 80 patients ranged in age from 6 to 68 years (mean
age = 35 years). The prevalence of resistant TB was 10.60% (80/755). Primary resistance accounted for 73.75% and
secondary resistance for 26.25%. The age group 20 - 39 years (57.50%),
male (72.50%), 8th district (17.50%), people living in couples (53.75%),
farmers (13.75%) were the socio-demographic
characteristics most affected by resistance. Treatment failure (13.75%),
relapses (13.75%), the notion of contagion (28.75%), a history of smoking (40%)
and alcohol (61.25%) were the clinical antecedents reported by the patients.
Treatment failure and relapse were the variables associated with the occurrence
of resistant PMT+ (p < 0.05). A considerable proportion of the overall Mycobacterium tuberculosis resistance to anti-tuberculosis drugs
(10.60%) was identified by GeneXpert. Treatment failure and relapse were the
factors associated with the risk of resistance.
References
[1]
Briand, M. (2018) Tuberculose multirésistante: Stratégies thérapeutiques actuelles et place de la bédaquiline (Sirturo).
[2]
Veziris, N. and Robert, J. (2010) Anti-Tuberculosis Drug Resistance and Therapeutic Dead End. Medecine/Sciences, 26, 976-980. https://doi.org/10.1051/medsci/20102611976
[3]
Diande, S. (2010) Evaluation de la Resistance de Mycobacterium tuberculosis Aux Antibiotiques et Exploration des Facteurs de Risque Associes a La Multiresistance Au Burkina Faso, 113.
[4]
Tékpa, G., Fikouma, V., Téngothi, R.M.M., Longo, J.D., Woyengba, A.P.A. and Koffi, B. (2019) Epidemiological and Clinical Features of Tuberculosis at the Hopital de l’Amitié in Bangui. The Pan African Medical Journal, 33, Article No. 31. https://doi.org/10.11604/pamj.2019.33.31.13442
[5]
He, H., Yb, K., Fn, E., Ihbibane, F., Soraa, N., Tassi, N., et al. (2020) Apport du Test Xpert MTB/RIF dans le diagnostic et le traitement de la tuberculose. The Contribution of the Xpert MTB/RIF Test in the Diagnosis and Treatment of Tuberculosis. Revue Malienne d’Infectiologie et de Microbiologie, 16, 36-40. https://doi.org/10.53597/remim.v16i2.1868
[6]
Irish, C., Herbert, H., Bennett, D., Gilham, C. and Drobniewski, F. (1999) Database Study of Antibiotic Resistant Tuberculosis in the United Kingdom. BMJ, 318, 497-498. https://doi.org/10.1136/bmj.318.7182.497
[7]
Ilboudo, D., Bisseye, C., Djigma, F., Diande, S. and Yonli, A. (2015) Diagnostic moléculaire du complexe Mycobacterium tuberculosis résistant à l’isoniazide et à la rifampicine au Burkina Faso. The Pan African Medical Journal, 21, Article No. 73. https://doi.org/10.11604/pamj.2015.21.73.5494
[8]
Labie, D. (2007) Mycobacterium tuberculosis. Médecine/Sciences, 23, 205-209. https://doi.org/10.1051/medsci/2007232205
[9]
Smaoui, F.S., Mzid, H., Marouane, C. and Kammoun, S. (2015) Multidrug-Resistant Tuberculosis: Epidemiology and Risk Factors. Revue de Pneumologie Clinique, 71, 233-241. https://doi.org/10.1016/j.pneumo.2015.03.004
[10]
Mjid, M., Hedhli, A., Zakhma, M., Zribi, M., Ouahchi, Y. and Toujani, S. (2018) Clinical and Microbiological Profile of Patients Experiencing Relapses of Tuberculosis in Tunisia. Revue de Pneumologie Clinique, 74, 76-80. https://doi.org/10.1016/j.pneumo.2018.01.002
[11]
Chia, B.S., Lanzas, F., Rifat, D., Herrera, A., Kim, E.Y., Sailer, C., et al. (2012) Use of Multiplex Allele-Specific Polymerase Chain Reaction (MAS-PCR) to Detect Multidrug-Resistant Tuberculosis in Panama. PLOS ONE, 7, e0040456. https://doi.org/10.1371/journal.pone.0040456
[12]
Xavier, L. and Nouvel, M. (2005) Recherche de marqueurs génétiques de souches de Mycobacterium tuberculosis multirésistantes aux antibiotiques en République Centrafricaine.
[13]
Laoulet, K.T., Mossoro-Kpindé, C.D. and Pamatika, C.M. (2021) Dépistage systématique du VIH chez les patients suspects de tuberculose pulmonaire au Centre de Santé Urbain de Malimaka à Bangui. Médecine d’Afrique Noire, 68, 32-38.
[14]
Helbling, P., Altpeter, E., Raeber, P.A., Pfyffer, G.E. and Zellweger, J.P. (2000) Surveillance of Antituberculosis Drug Resistance in Switzerland 1995-1997: The Central Link. European Respiratory Journal, 16, 200-202. https://doi.org/10.1034/j.1399-3003.2000.16b03.x
[15]
Sante, D. (2000) Cinquante-Troisieme Cinquante-Troisieme. 15-20.
[16]
Caminero, J.A. (2010) Multidrug-Resistant Tuberculosis: Epidemiology, Risk Factors and Case Finding. The International Journal of Tuberculosis and Lung Disease, 14, 382-390.
[17]
Niang, S., Abdallahi, E.W., Thiam, K., Mbaye, F.B.R., Cissé, M.F., Ndiaye, E.M. and Badiane, N.T. (2018) Aspects épidémiologiques, diagnostiques et évolutifs de la tuberculose pulmonaire à microscopie positive au District Sanitaire de Saint-Louis. Epidemiological, Diagnostic and Evolutionary Aspects of Pulmonary Tuberculosis with Positive Microscopy in the S. Revue Africaine de Médecine Interne, 5, 65-69.
[18]
Sahebi, L., Ansarin, K., Seyyedi, M., Monfaredan, A., Farajnia, S., Moaddab, S.R., et al. (2016) Epidemiology and Patterns of Drug Resistance among Tuberculosis Patients in Northwestern Iran. Indian Journal of Medical Microbiology, 34, 362-368. https://doi.org/10.4103/0255-0857.188352
[19]
Man-Koumba, S., Kouamé, D.M., Constant, K.J., Harvey, A., Abdoulaye, O., Youssouf, T., et al. (2018) Épidémiologie de la tuberculose en Côte d’Ivoire: Une revue systématique de la littérature. Revue Internationale des Sciences Médicales, 20, 140-147.
[20]
Misombo-Kalabela, A., Nguefack-Tsague, G., Kalla, G.C.M., Ze, E.A., Diangs, K., Panda, T., et al. (2016) Facteurs de risque de la tuberculose multi-résistante dans la ville de Kinshasa en République Démocratique du Congo. The Pan African Medical Journal, 23, Article No. 157. https://doi.org/10.11604/pamj.2016.23.157.6137
