The burden of drug resistance tuberculosis in Ghana; results of the First National Survey
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Date
2021
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PLOS ONE
Abstract
Resistance to Tuberculosis drugs has become a major threat to the control of tuberculosis
(TB) globally. We conducted the first nation-wide drug resistance survey to investigate the
level and pattern of resistance to first-line TB drugs among newly and previously treated
sputum smear-positive TB cases. We also evaluated associations between potential risk
factors and TB drug resistance. Using the World Health Organization (WHO) guidelines on
conducting national TB surveys, we selected study participants from 33 health facilities from
across the country, grouped into 29 clusters, and included them into the survey. Between
April 2016 and June 2017, a total of 927 patients (859 new and 68 previously treated) were
enrolled in the survey. Mycobacterium tuberculosis complex (MTBC) isolates were
success fully cultured from 598 (65.5%) patient samples and underwent DST, 550 from
newly diag nosed and 48 from previously treated patients. The proportion of patients who
showed resistance to any of the TB drugs tested was 25.2% (95% CI; 21.8–28.9). The most frequent
resistance was to Streptomycin (STR) (12.3%), followed by Isoniazid (INH) (10.4%), with
Rifampicin (RIF), showing the least resistance of 2.4%. Resistance to Isoniazid and Rifampi cin
(multi-drug resistance) was found in 19 (3.2%; 95% CI: 1.9–4.9) isolates. Prevalence of
multidrug resistance was 7 (1.3%; 95% CI: 0.5–2.6) among newly diagnosed and 12
(25.0%; 95% CI: 13.6–39.6) among previously treated patients. At both univariate and multi variate
analysis, MDR-TB was positively associated with previous history of TB treatment
(OR = 5.09, 95% CI: 1.75–14.75, p = 0.003); (OR = 5.41, 95% CI: 1.69–17.30, p = 0.004).
The higher levels of MDR-TB and overall resistance to any TB drug among previously
treated patients raises concerns about adherence to treatment. This calls for strengthening
Description
This article is published by Plos One and is also available at https://doi.org/10.1371/
journal.pone.0252819
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Citation
ylverken AA, Kwarteng A, Twumasi Ankrah S, Owusu M, Arthur RA, Dumevi RM, et al. (2021) The burden of drug resistance tuberculosis in Ghana; results of the First National Survey. PLoS ONE 16(6): e0252819