Antituberculous Drug Resistance in Central Haiti

Scalcini, M; Carré, George; Michel, Jean-Baptiste; Hershfield, Earl S.; Parker, Shirley; Wolfe, Jonathan; Nelz, Katherina; Long, Richard

doi:10.1164/ajrccm/142.3.508

Cited by 31 publications

(15 citation statements)

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“…The age of the patients and previous history of hepatic cirrhosis were also independent risk factors in the presence of resistance to antituberculosis drugs. SCALCINI et al [30], in Haiti, described an increase in resistance with age, although other writers have not observed this relationship [2,4,16]. In our study, those patients who were 45 or more years of age presented a risk almost four times higher than those of less than 45 yrs, even adjusting for other potential risk factors.…”

Section: Discussioncontrasting

confidence: 64%

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

Arevalo¹,

Solera²,

Cebrián³

et al. 1996

Eur Respir J

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The aim of this study was to investigate the incidence of primary and secondary resistance to antituberculosis drugs and the risk factors associated with the resistance in southeast Spain.Our research was based on the clinical histories of 276 patients, diagnosed as having tuberculosis by positive culture, who were tested for drug susceptibility between January 1988 and October 1994. The clinical histories were checked by two independent investigators. Drug-resistant strains were isolated from 24 patients (8.7%). Among the 239 patients without previous tuberculosis therapy, 7 (2.9%) were drug-resistant. Among the 37 patients with previous therapy, 17 (46%) were drug-resistant. Seventeen of the 276 patients (6.2%) had resistance to a single drug. Primary resistance to isoniazid was 1.7%. Previous treatment for tuberculosis (odds ratio (OR) 39.2; 95% confidence interval (95% CI) 10.2-150); hepatic cirrhosis (OR 104; 95% CI 12.8-847); and age 45 yrs and older (OR 4.80; 95% CI 1.15-20.1) were considered risk factors associated with drug-resistant tuberculosis.We conclude that primary and secondary resistance is low in the southeast of Spain and we recommend that susceptibility testing be performed on initial M. tuberculosis isolated from patients with a history of previous tuberculosis therapy, hepatic cirrhosis or more than 44 yrs of age.

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Section: Discussioncontrasting

confidence: 64%

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

Arevalo¹,

Solera²,

Cebrián³

et al. 1996

Eur Respir J

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“…(7,8) Studies from the neighboring Dominican Republic, which shares the island of Hispanola with Haiti, also have shown high MDR-TB rate of 10.2% in all cases and 6.6% of new TB cases. (11) Given the large amount of immigration between countries throughout the western hemisphere, the results of these studies are of particular concern for the spread of previously localized disease.…”

Section: Discussionmentioning

confidence: 99%

“…In a 1990 study, the rate of isoniazid resistance was 19% but multidrug resistant tuberculosis (MDR-TB), defined as resistance to both isoniazid and rifampin, was not found in any patient with new tuberculosis. (7) In a 1991 study of recent migrants from Haiti to Cuba, single drug resistance to isoniazid was found in 22% of TB patients but MDR-TB was not found. (8) However, a study in 2002 of patients presenting to an HIV/AIDS center in Port au Prince with new onset tuberculosis found a rate of primary multidrug-resistant tuberculosis of 6%.…”

Section: Introductionmentioning

confidence: 99%

Multidrug-resistant tuberculosis in Port-au-Prince, Haiti

Ocheretina¹,

Morose²,

Gauthier³

et al. 2012

Rev Panam Salud Publica

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Objectives Determine the prevalence of MDR-TB among patients with new smear-positive pulmonary TB in Port au Prince, Haiti Methods Sputum samples were cultured from 1006 patients diagnosed with new tuberculosis in 2008. The core region of the rpoB gene that is associated with resistance to rifampin was sequenced. All isolates with rpoB mutations were sent to the NY State reference laboratory for conventional drug susceptibility testing (DST). All isolates were also tested with the GenoType MTBDRplus line probe assay. Results M.tubercuosis was isolated from 906 patients. 26 (2.9%) of the isolates had mis-sense mutations or deletions in rpoB and were resistant to rifampin by DST. All 26 were also resistant to isoniazid and classified as MDR-TB. 46 control isolates without rpoB mutations were all found to be rifampin-sensitive by DST. The GenoType MTBDRplus line probe assay correctly identified 26 MDR-TB strains. It misclassified 1 pansusceptible isolate as RIF-resistant. Conclusions This study shows an MDR-TB prevalence of 2.9% in newly diagnosed TB patients in Haiti and also suggests that rpoB sequencing or hybridization assays are good screening tools for early detection of MDR-TB.

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“…Laboratory data: Isolates were processed with the radiometric system (BACTEC 460, Becton-Dickinson Diagnostic Instrument Systems, Maryland). Details of this method have been described previously (6). In each provincial mycobacterialogy laboratory the BACTEC system had been validated against the proportion method used by the Laboratory Centre for Disease Control, Ottawa, Ontario.…”

Section: Methodsmentioning

confidence: 99%

Antituberculous Drug Resistance in Western Canada (1993 to 1994)

Long

Fanning²,

Cowie³

et al. 1997

Canadian Respiratory Journal

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OBJECTIVES: To estimate the magnitude of antituberculous drug resistance and identify prospectively the risk factors for its development in tuberculosis (TB) patients in western Canada over a one-year period.DESIGN: Comparison of drug-resistant and nondrug-resistant cases of TB.SETTING: Western Canada.PATIENTS: All people with TB reported to the TB registries of Manitoba, British Columbia, Alberta and Saskatchewan between February 1, 1993 and January 31, 1994.MAIN OUTCOME MEASURES: Drug susceptibility testing was performed in all cases of culture-positive tuberculosis. Patients at risk for human immunodeficiency virus (HIV) infection were serotested.RESULTS: Of 534 culture positive cases of TB, 37 (6.9%) were drug resistant. Odds ratios suggested that the risk of drug resistance was significantly higher among those with reactivation than among those with new disease, and among those born outside of Canada than among those born in Canada. Ninety per cent of the foreign-born patients with drug-resistant disease were from Asia. Of the 35 patients with drug resistance whose type of resistance was known, 76% had initial and 24% had acquired drug resistance. The initial resistance rate in Asian-born patients was 14%. Most of the 37 drug-resistant cases were resistant to isoniazid (68%), streptomycin (49%) or both (22%). Twelve (32%) of the 37 cases were resistant to two or more first-line drugs. Of 14 patients who were HIV seropositive only one, a foreign-born patient, was drug resistant.CONCLUSION: Antituberculous drug resistance is low among Canadian-born patients in western Canada, but not uncommon among those born outside Canada. Initial therapy of foreign-born patients should include four first-line drugs.

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Antituberculous Drug Resistance in Central Haiti

Cited by 31 publications

References 1 publication

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

Multidrug-resistant tuberculosis in Port-au-Prince, Haiti

Antituberculous Drug Resistance in Western Canada (1993 to 1994)

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