Patterns of initial and acquired antituberculosis drug resistance in Karonga District, Malawi

Glynn, J.R.; Fine, P. E. M.; Sterne, J. A. C.; Bliss, L.; Jenkins, Paul; Pönnighaus, J. M.; Mkandwire, P.K.; Nyasulu, S.; Warndorff, D. K.

doi:10.1016/s0140-6736(95)90016-0

Cited by 23 publications

(19 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the small number of tested samples (61 strains), the lack of streptomycin-resistant strains and the low level of isoniazid resistance are surprising. Indeed, many studies showed that resistance to streptomycin and isoniazid was most frequent in sub-Saharan Africa (2,7,10). The high rate of resistance to these drugs is related to the intensive use of low-cost or free drugs (2, 7).…”

Section: Discussionmentioning

confidence: 99%

First Molecular Epidemiology Study ofMycobacterium tuberculosisin Burkina Faso

et al. 2007

View full text Add to dashboard Cite

We conducted a molecular epidemiology study on 120 Mycobacterium tuberculosis isolates from patients presenting pulmonary tuberculosis (TB) in Burkina Faso. Classical antibiogram studies and genetic characterization, using mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing and spoligotyping, were applied after culture. Molecular analysis of specific signatures showed that all TB cases reported in this study were caused by M. tuberculosis and identified no Mycobacterium bovis or Mycobacterium africanum isolates. This result is unexpected, as M. africanum strains were reportedly the etiologic agent in 20% of TB cases 2 decades ago. The comparison of spoligotypes from Burkina Faso with an international spoligotype database (SpolDB4) showed that the majority of isolates belong to major clades of M. tuberculosis (Haarlem, 9%; Latin American-Mediterranean, 30%; and T, 20%). The predominant group of isolates (30%) corresponds to spoligotype 61, described in Cameroon as the "Cameroon family." In Burkina Faso, as in Cameroon, this family could be associated with recent transmission of TB, suggesting a recent expansion in West Africa. Our data suggest a low level of primary drug resistance that may be a positive result of the Directly Observed Therapy Shortcourse program. Besides, based on spoligotyping plus MIRU-VNTR, data showed a high number of clusters in our sample, suggesting a high level of recent TB transmission in Burkina Faso. Nevertheless, an important genetic polymorphism was observed in this country, reflecting an endemicity situation where the control of TB would have less impact in the main towns.

show abstract

Section: Discussionmentioning

confidence: 99%

First Molecular Epidemiology Study ofMycobacterium tuberculosisin Burkina Faso

et al. 2007

View full text Add to dashboard Cite

show abstract

“…It has also been postulated that HIV-infected individuals could be more susceptible to drug-resistant strains that may have reduced virulence. However, the lack of association between HIV and drug resistance in African studies suggests that differences in exposure are a more important explanation [10].…”

Section: Hiv Infectionmentioning

confidence: 99%

“…HIV has been found to be a risk factor for resistance in the United States [5,[7][8][9] but not in Africa [10]. Some studies have found resistance to be associated with cavitatory pulmonary disease [11], and most studies from developed countries (particularly the United States) have found relationships with ethnic groupings [5,7], foreign birth [7,[12][13][14] and urban centres [13].…”

Section: Introductionmentioning

confidence: 99%

Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance

Conaty

Hayward

Story³

et al. 2004

Epidemiol. Infect.

View full text Add to dashboard Cite

“…Diagnostic methods (tuberculosis bacteriology and leprosy biopsies) are described in detail elsewhere [14,15].…”

Section: Tuberculosis and Leprosymentioning

confidence: 99%

Environmental mycobacteria in northern Malawi: implications for the epidemiology of tuberculosis and leprosy

et al. 2001

View full text Add to dashboard Cite

SUMMARYMore than 36 000 individuals living in rural Malawi were skin tested with antigens derived from 12 different species of environmental mycobacteria. Most were simultaneously tested with RT23 tuberculin, and all were followed up for both tuberculosis and leprosy incidence. Skin test results indicated widespread sensitivity to the environmental antigens, in particular to Mycobacterium scrofulaceum, M. intracellulare and one strain of M. fortuitum. Individuals with evidence of exposure to ' fast growers ' (i.e. with induration to antigens from fast growers which exceeded their sensitivity to tuberculin), but not those exposed to ' slow growers ', were at reduced risk of contracting both tuberculosis and leprosy, compared to individuals whose indurations to the environmental antigen were less than that to tuberculin. This evidence for cross protection from natural exposure to certain environmental mycobacteria may explain geographic distributions of mycobacterial disease and has important implications for the mechanisms and measurement of protection by mycobacterial vaccines.

show abstract

Patterns of initial and acquired antituberculosis drug resistance in Karonga District, Malawi

Cited by 23 publications

References 11 publications

First Molecular Epidemiology Study ofMycobacterium tuberculosisin Burkina Faso

First Molecular Epidemiology Study ofMycobacterium tuberculosisin Burkina Faso

Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance

Environmental mycobacteria in northern Malawi: implications for the epidemiology of tuberculosis and leprosy

Contact Info

Product

Resources

About