Rates of Anti-Tuberculosis Drug Resistance in Kampala-Uganda Are Low and Not Associated with HIV Infection

Lukoye, Deus; Cobelens, Frank; Ezati, Nicholas; Kirimunda, Samuel; Adatu, Francis; Lule, Joseph K. Konde; Nuwaha, Fred; Joloba, Moses

doi:10.1371/journal.pone.0016130

Cited by 42 publications

(57 citation statements)

References 8 publications

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“…5 In a recent study performed in Kampala, 1.1% of 473 new cases were MDR-TB. 11 The last published information on drug resistance for Kenya dates from 13,14 Despite the limited number of previously treated cases, the proportion of MDR-TB was higher among previously treated cases than among new cases, as expected. No extensively drug-resistant TB cases were detected at any of the sites.…”

Section: Discussionsupporting

confidence: 52%

“…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.…”

Section: Discussionmentioning

confidence: 96%

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

Sánchez-Padilla¹,

Ardizzoni²,

Sauvageot

et al. 2012

int j tuberc lung dis

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 96%

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

Sánchez-Padilla¹,

Ardizzoni²,

Sauvageot

et al. 2012

int j tuberc lung dis

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“…However, estimates of primary resistance to isoniazid in HIV-infected individuals in all three trial settings were low, ranging from 3.8% in Soweto (6), 7.5% in Nairobi (34), and 4-9% in Uganda (35,36), and unlikely to affect our results. A recent national drug resistance survey in Uganda found that primary isoniazid resistance has remained low at 5% (37).…”

Section: Discussionmentioning

confidence: 69%

Ability of preventive therapy to cure latent Mycobacterium tuberculosis infection in HIV-infected individuals in high-burden settings

Houben¹,

Sumner²,

Grant

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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Trials of isoniazid preventive therapy (IPT) for people living with HIV in southern Africa have shown high rates of tuberculosis disease immediately after cessation of therapy. This could be due to the lack of cure following preventive therapy or reinfection with rapid progression to disease. Using a model fitted to trial data, we estimate the degree to which preventive therapies cure latent Mycobacterium tuberculosis infection in HIV-infected individuals in high-tuberculosis-burden settings. We identified randomized controlled trials that compared IPT to placebo or alternative regimen in HIV-positive, tuberculin skin test positive individuals. A mathematical model describing tuberculosis transmission in a closed cohort of HIV-positive, M. tuberculosis infected, antiretroviral therapy naive individuals following completion of preventive therapy (or placebo) was fitted to posttherapy tuberculosis rates to estimate the annual risk of M. tuberculosis reinfection and the proportion of individuals whose latent infection was cured after therapy. Three trials met our inclusion criteria. Estimated annual risks of reinfection ranged between 3.7 and 4.9%. Our results suggest 6 mo of isoniazid cured in a small proportion [estimated proportion cured = 0% (interquartile range 0-30.9%)]. The proportion cured for 3-mo regimens containing rifampicin or rifapentine was 19-100%. IPT alone does not cure existing infections in the majority of HIV-infected individuals. In high-incidence settings, continuous IPT should be integrated with HIV care. Where the risk of reinfection is lower, preventive therapy with more curative drugs should be preferred for HIV-positive individuals to achieve durable patient benefit.

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“…An estimated 18 to 20% of all TB cases reported to the National Tuberculosis and Leprosy Program (NTLP) come from this city, making Kampala the highest-TB-burdened district in Uganda (NTLP unpublished data). Anti-TB drug resistance and TB-HIV coinfection rates are similar to those for the entire country (16).…”

mentioning

confidence: 58%

The T2 Mycobacterium tuberculosis Genotype, Predominant in Kampala, Uganda, Shows Negative Correlation with Antituberculosis Drug Resistance

Lukoye¹,

Katabazi²,

Musisi³

et al. 2014

Antimicrob Agents Chemother

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e Surveillance of the circulating Mycobacterium tuberculosis complex (MTC) strains in a given locality is important for understanding tuberculosis (TB) epidemiology. We performed molecular epidemiological studies on sputum smear-positive isolates that were collected for anti-TB drug resistance surveillance to establish the variability of MTC lineages with anti-TB drug resistance and HIV infection. Spoligotyping was performed to determine MTC phylogenetic lineages. We compared patients' MTC lineages with drug susceptibility testing (DST) patterns and HIV serostatus. , 5.0; 95% CI, 2.0 to 11.9; P < 0.001) and CAS (OR adj , 2.9; 95% CI, 1.4.0 to 6.3; P ‫؍‬ 0.006) families were more likely to show any resistance than was T2. All other MTC lineages combined were more likely to be resistant to any of the anti-TB drugs than were the T2 strains (OR adj , 1.7; 95% CI, 1.0 to 2.9; P ‫؍‬ 0.040). There were no significant associations between multidrug resistance and MTC lineages, but numbers of multidrug-resistant TB strains were small. No association was established between MTC lineages and HIV status. In conclusion, the T2 MTC lineage negatively correlates with anti-TB drug resistance, which might partly explain the reported low levels of anti-TB drug resistance in Kampala, Uganda. Patients' HIV status plays no role with respect to the MTC lineage distribution.

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Rates of Anti-Tuberculosis Drug Resistance in Kampala-Uganda Are Low and Not Associated with HIV Infection

Cited by 42 publications

References 8 publications

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

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

Ability of preventive therapy to cure latent Mycobacterium tuberculosis infection in HIV-infected individuals in high-burden settings

The T2 Mycobacterium tuberculosis Genotype, Predominant in Kampala, Uganda, Shows Negative Correlation with Antituberculosis Drug Resistance

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