Drug resistant TB – latest developments in epidemiology, diagnostics and management

Tiberi, Simon; Utjesanovic, Natasa; Galvin, Jessica; Centis, Rosella; D’Ambrosio, Lia; Boom, Martin van den; Zumla, Alimuddin; Migliori, Giovanni Battista

doi:10.1016/j.ijid.2022.03.026

Cited by 60 publications

(43 citation statements)

References 40 publications

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“…Drug-resistant Mycobacterium is one of the most urgent and difficult challenges facing global tuberculosis (TB) control, with more than half million cases reported worldwide in 2020. 1 , 2 Early case detection of Mycobacterium tuberculosis (MTB) and appropriate case management are key steps to minimize the high risk of human-to-human transmission of the disease and to the success of TB treatment. 3 Since 2010, the World Health Organization began to recommend the utilization of GeneXpert MTB/RIF assay that simultaneously detect TB and rifampicin (RIF) rapidly in people with signs and symptoms of TB.…”

Section: Introductionmentioning

confidence: 99%

Rifampicin resistant Mycobacterium tuberculosis and associated factors among presumptive pulmonary tuberculosis patients in Mogadishu, Somalia

et al. 2023

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Background: Multi-drug resistant Mycobacterium tuberculosis is a growing public health problem in developing countries including Somalia. Although, the prevalence of multi-drug resistant tuberculosis among new and retreated cases is high, data on GeneXpert- Mycobacterium tuberculosis/rifampicin-resistant assay, which is a surrogate marker for multidrug resistance, is not well explored in Mogadishu. Objectives: To determine the prevalence of rifampicin-resistant Mycobacterium tuberculosis and its associated factors among presumptive pulmonary tuberculosis patients visiting tuberculosis centers in Mogadishu, Somalia. Methods: A multicenter cross-sectional study was conducted in three tuberculosis treatment centers from March 12 to April 30, 2021. Laboratory professionals collected sputum sample consecutively from presumptive pulmonary tuberculosis participants and performed a GeneXpert assay to determine the rifampicin resistance. Socio-demographic and clinical data were collected using structured questionnaire. Logistic regression analyses were performed to assess factors associated with rifampicin resistance using an adjusted odds ratio at a 95% confidence interval. Statistical significance was considered at a p-value of less than 0.05. Results: A total of 370 presumptive tuberculosis suspects were included; of whom 58.4% were females and the mean age of the participants was 44.3 ± 14 years. Mycobacterium tuberculosis was detected in 63 (17%) (95% confidence interval = 13.2–20.8) suspects. Of these the prevalence of rifampicin-resistant Mycobacterium tuberculosis was 35% (95% confidence interval = 30.2–39.8). Anti-tuberculosis treatment history (adjusted odds ratio = 4.1; 95% confidence interval = 1.91–6.75), monthly income less than $100 USD (adjusted odds ratio = 2.2; 95% confidence interval = 1.77–5.98) and being diagnosed with Asthma (adjusted odds ratio = 2.63; 95% confidence interval = 1.3–7.3) were significantly associated with rifampicin-resistant tuberculosis. Conclusion: A considerable proportion of rifampicin-resistant tuberculosis is reported in these study settings. The strong association between multidrug resistance tuberculosis and patients’ retreatment history of tuberculosis, low income, and co-morbidity with asthma highlights the need for more efforts in tuberculosis treatment and monitoring programs to limit the emergence of multi-drug resistant strain in the study areas.

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Section: Introductionmentioning

confidence: 99%

Rifampicin resistant Mycobacterium tuberculosis and associated factors among presumptive pulmonary tuberculosis patients in Mogadishu, Somalia

et al. 2023

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“…Another research reported that each year Mycobacterium tuberculosis-infected more than half a million new cases of RR-TB and MDR-TB with resistance to isoniazid and rifampicin [ 6 ]. Despite the enormous development in medical sciences, present-day DR-TB carry on as an international health combination and is explained by sky-scarping morbidity and mortality, poorer clinical outcome, high expense, and raised complicated clinical scenario for appropriate pharmacological intervention [ 55 , 56 ].…”

Section: Reviewmentioning

confidence: 99%

Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB) Among Children: Where We Stand Now

Chowdhury¹,

Ahmad²,

Sinha³

et al. 2023

Cureus

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Drug-resistant tuberculosis (DR-TB) has continued to be a global health cataclysm. It is an arduous condition to tackle but is curable with the proper choice of drug and adherence to the drug therapy. WHO has introduced newer drugs with all-oral shorter regimens, but the COVID-19 pandemic has disrupted the achievements and raised the severity. The COVID-19 controlling mechanism is based on social distancing, using face masks, personal protective equipment, medical glove, head shoe cover, face shield, goggles, hand hygiene, and many more. Around the globe, national and international health authorities impose lockdown and movement control orders to ensure social distancing and prevent transmission of COVID-19 infection. Therefore, WHO proposed a TB control program impaired during a pandemic. Children, the most vulnerable group, suffer more from the drug-resistant form and act as the storehouse of future fatal cases. It has dire effects on physical health and hampers their mental health and academic career. Treatment of drug-resistant cases has more success stories in children than adults, but enrollment for treatment has been persistently low in this age group. Despite that, drug-resistant childhood tuberculosis has been neglected, and proper surveillance has not yet been achieved. Insufficient reporting, lack of appropriate screening tools for children, less accessibility to the treatment facility, inadequate awareness, and reduced funding for TB have worsened the situation. All these have resulted in jeopardizing our dream to terminate this deadly condition. So, it is high time to focus on this issue to achieve our Sustainable Development Goals (SDGs), the goal of ending TB by 2030, as planned by WHO. This review explores childhood TB's current position and areas to improve. This review utilized electronic-based data searched through PubMed, Google Scholar, Google Search Engine, Science Direct, and Embase.

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“…The current recommended treatment consists of a 2-month intensive treatment regimen with isoniazid, rifampicin, pyrazinamide, and ethambutol, followed by a 4-month continuation phase with an isoniazid–rifampicin combination for new patients with pulmonary and some cases of extrapulmonary TB [ 4 , 5 ]. Longer treatment is required for some extrapulmonary TB cases (central nervous system, bones, and joints), or multi-drug-resistant TB [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of Response at 2 Months of Treatment in a Cohort of Pakistani Patients with Pulmonary Tuberculosis

Shah

Khan²,

Shahzad³

et al. 2022

Antibiotics

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Mycobacterium tuberculosis infection continues to be a major global challenge. All patients with pulmonary tuberculosis are treated with a standard 6-month treatment regimen. Historical data suggest that even with shortened treatment, most patients achieve long-term remission. Risk stratification is a goal for reducing potentially toxic prolonged treatment. This study aimed to determine the factors associated with the early clearance of sputum acid-fast bacilli (AFB). A total of 297 freshly diagnosed patients with pulmonary tuberculosis were included and enrolled in this study. Information related to their ethno-demographic and anthropometric characteristics was collected. We also assessed their complete blood counts, and blood iron, folate, and vitamin B12 levels. We found that the presence of higher levels of acid-fast bacilli (AFB) in diagnostic sputum microscopy was the single most significant prognostic factor associated with early clearance of sputum AFB after 2 months of treatment. All of our patients achieved treatment success after 6 months of treatment and were disease free. Our results support the data obtained from previous studies indicating that AFB clearance at 2 months is unlikely to be a clinically useful biomarker or indicator for therapeutic stratification. Furthermore, demographic, anthropometric, and nutritional factors are not clinically useful biomarkers.

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Drug resistant TB – latest developments in epidemiology, diagnostics and management

Cited by 60 publications

References 40 publications

Rifampicin resistant Mycobacterium tuberculosis and associated factors among presumptive pulmonary tuberculosis patients in Mogadishu, Somalia

Rifampicin resistant Mycobacterium tuberculosis and associated factors among presumptive pulmonary tuberculosis patients in Mogadishu, Somalia

Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB) Among Children: Where We Stand Now

Determinants of Response at 2 Months of Treatment in a Cohort of Pakistani Patients with Pulmonary Tuberculosis

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