Antituberculosis Drugs Resistance and Treatment Outcomes Among Retreatment Patients in Guinea: A Five-Year Retrospective Cohort Study
Science Journal of Public Health
Volume 7, Issue 5, September 2019, Pages: 167-173
Received: Sep. 9, 2019; Accepted: Sep. 24, 2019; Published: Oct. 11, 2019
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Authors
Tamba Kallas Tonguino, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
Tamba Mina Millimouno, Research Unit, National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea
Boubacar Djelo Diallo, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
Alexandre Delamou, Research Unit, National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea; Department of Public Health, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
Nimer Ortuno Gutierrez, Tuberculosis Control Project, Action Damien, Conakry, Guinea
Mory Camara, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
Boubacar Bah, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
Oumou Younoussa Sow, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
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Abstract
Tuberculosis (TB) is a global outbreak whose drug resistance is a constant threat. This study aimed at describing anti-TB drugs resistance and treatment outcomes among retreatment TB patients in Guinea between 2008 and 2012. We conducted a retrospective cohort study with a sample of 558 patients aged of at least 10, who were admitted for TB retreatment and who were tested for anti-TB drugs susceptibility during the study period. Overall, 3187 retreatment TB patients were recorded from January 1, 2008 to December 31, 2012 in Guinea, of which 558 (17.5%) performed susceptibility testing to anti-TB drugs. We found overall resistance in 417 cases (74.7%) including 356 (85.4%) of multidrug resistance (MDR), 29 (6.9%) of monoresistance (isoniazid 2.9%, streptomycin 2.9%, rifampicin 0.9%, ethambutol 0.2%) and 32 (7.7% of polydrug resistance (isoniazid + streptomycin 4.3%, rifampicin + streptomycin 1.4%, isoniazid + ethambutol + streptomycin 1.0%, rifampicin + ethambutol + streptomycin 1.0%). Most of the patients (84.6%) with anti-TB drugs resistance were under 45 and labourers were mostly represented (27.8%) including drivers in majority (37.9%). MDR-TB incidence rate increased by 12.2% between 2008 (65.6%) and 2012 (77.8%), and the annual cure rate decreased gradually from 60.0% in 2009 to 45.7% in 2012. Among MDR-TB patients (n= 356), only 112 (31.5%) benefited from second-line treatment regimen, of which, 51.7% were cured, 6.3% completed treatment, 24.1% died, 6.3% were lost to follow-up and 11.6% were not evaluated. The cure rate was higher in HIV-negative patients (55.3%) than in those who were HIV-positive (35.3%) and the death rate was the highest (41.2%) in HIV-positive patients. Overall, treatment success rate was 58.0%. This study revealed a low rate of performing drug susceptibility testing, the gradual increase of the incidence of MDR-TB each year and the gradual decrease of cure rate from year to year. Besides, anti-TB drugs resistance concerned mostly drivers in our context. Prospective studies are needed for a deep understanding of the factors associated with these persistent challenges.
Keywords
Antituberculosis, Resistance, Treatment Outcome, Retreatment Patients, Guinea
To cite this article
Tamba Kallas Tonguino, Tamba Mina Millimouno, Boubacar Djelo Diallo, Alexandre Delamou, Nimer Ortuno Gutierrez, Mory Camara, Boubacar Bah, Oumou Younoussa Sow, Antituberculosis Drugs Resistance and Treatment Outcomes Among Retreatment Patients in Guinea: A Five-Year Retrospective Cohort Study, Science Journal of Public Health. Vol. 7, No. 5, 2019, pp. 167-173. doi: 10.11648/j.sjph.20190705.16
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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