High Prevalence of Multidrug-Resistant Tuberculosis, Swaziland, 2009–2010

Abstract

One third of previously treated patients had MDR TB.

The impact of total antioxidant capacity on pulmonary function in asthma patients

“…Although poorly documented in population-based studies, the association between HIV infection and DR-TB remains controversial in sub-Saharan Africa. 11,[15][16][17] An independent association was reported in the last national drug resistance survey in Swaziland, a Table 3 Multidrug and isoniazid resistance among new TB and HIV co-infected patients Homa Bay, Kenya (n = 221) FLD = first-line drugs; TB = tuberculosis; H = isoniazid; R = rifampicin; E = ethambutol; S = streptomycin; MDR-TB = multidrug-resistant TB. country with very high HIV and DR-TB prevalence.…”

“…The prevalence of INH resistance is higher than that reported by former Kenyan (7.3%) and Ugandan national surveys (6.7%), and was similar (16%) to previous reports in another district of Malawi (Karonga) in 1997-1998. 5,6,15 Using the standard 6-month treatment regimen, one in 10 new cases would receive RMP monotherapy during the continuation phase, with the potential risk of acquiring RMP resistance. These patients would benefi t from rapid DST for INH resistance to initiate effective treatment and prevent the additional acquisition of RMP resistance.…”

Detection of Drug-Resistant Tuberculosis by Xpert MTB/RIF in Swaziland

“…3 We found that 38 of 125 multidrug-resistant strains (30%) that were isolated during the survey carried the rpoB I491F mutation, which confers resistance to rifampin (Table 1; and the Supplementary Appendix, available with the full text of this letter at NEJM .org). This mutation, which was previously reported with low frequency in clinical isolates from Hong Kong and Australia, 4 is not detected by the Xpert MTB/RIF assay.…”

Countrywide roll-out of Xpert<SUP>®</SUP> MTB/RIF in Swaziland: the first three years of implementation

“…10 National TB control efforts have been complicated by the associated HIV-TB epidemic, with co-infection rates estimated at 80% and increasing MDR-TB rates of 7.7% in new cases and 33.8% in retreatment cases. 11,12 Swaziland declared TB a national emergency on 24 March 2011. 11 The focus of the NTCP is on expanding access to directly observed treatment (DOT), diagnostic services, treatment especially for drug-resistant TB and strengthening health systems.…”