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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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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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.
Antituberculosis, Resistance, Treatment Outcome, Retreatment Patients, Guinea
To cite this article
Tamba Kallas Tonguino,
Tamba Mina Millimouno,
Boubacar Djelo Diallo,
Nimer Ortuno Gutierrez,
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.
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.
Organisation Mondiale de la Santé (OMS). Mettre fin à la tuberculose d’ici 2030: cadre pour la mise en œuvre de la “stratégie de l’OMS pour mettre fin a la tuberculose” dans la région africaine au cours de la période 2016 – 2020. OMS, Bureau régional de l’Afrique. 2017.
World Health Organization, Global Tuberculosis Report 2018, WHO/CDS/TB/2018.20. World Health Organization, Geneva, Switzerland, 2018. Available at: https://www.who.int/tb/publications/global_report/en/; Accessed on August 16, 2019.
Organisation Mondiale de la Santé, Rapport sur la lutte contre la tuberculose dans le monde en 2017: Résumé d’orientation. Génève, 2017.
Meyssonnier V. Epidémiologie de la tuberculose et de la résistance aux antituberculeux. Université Pierre et Marie Curie-Paris VI; 2012 [cited 2016 May 19]. Available from: https://tel.archives-ouvertes.fr/tel-00833269/
Organisation Mondiale de la Santé. Tuberculose (TB): Impact mondial de la tuberculose. OMS, Bureau régional de l’Afrique. 2017
World Health Assembly. Resolution A67/11. United Nations. 2014.
Organisation Mondiale de la Santé (OMS). Rapport sur la lutte contre la tuberculose dans le monde. OMS, Genève, 2013. Google Sch.
World Health Assembly. Resolution A/RES/71/4. United Nations. 2018. Available at: http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_4-en.pdf?ua=1
OMS Rapport sur la lutte contre la tuberculose dans le monde. 2011. WHO/HTM/TB/2011.16. Disponible sur (dernier accès: 05; 2012).
Veziris N, Jarlier V and Robert J. La résistance aux antituberculeux en France en 2009 2010. Bull Épidemiologique Hebdomadair. 2012; 24: 25.
Veziris N and Robert J. Résistance aux antituberculeux et impasse thérapeutique. MS Médecine Sci. 2010; 26 (11): 976–80.
Ade S, Adjibodé O, Wachinou P, Toundoh N, Awanou B and Agodokpessi G. Characteristics and Treatment Outcomes of Retreatment Tuberculosis Patients in Benin. Hindawi Publishing Corporation Tuberculosis Research and Treatment Volume 2016, Article ID 1468631, 7 pages http://dx.doi.org/10.1155/2016/1468631
Sangaré L, Diandé S, Badoum G, Dingtoumda B and Traoré AS. Résistance aux antituberculeux chez les cas de tuberculose pulmonaire nouveaux ou traités antérieurement au Burkina Faso. Int J Tuberc Lung Dis. 2010; 14 (11): 1424–9.
World Health Organization. Global tuberculosis report 2015. Geneva, Switzerland: World Health Organization; 2015.
Ministère de la Santé. Guide de prise en charge de la tuberculose pharmacorésistante en Guinée. PNLAT; 2012.
Institut National de la Statistique, Récensement Général de la Population et de l'Habitation (RGPH). Guinée: Institut National de la Statistique. Avril 2014. Available at: http://www.ins.ci/n/documents/RGPH2014_expo_dg.pdf. Accessed on: 15th April 2018.
World Health Organization, “Definitions and reporting framework for tuberculosis_2013 revision,” Tech. Rep.WHO/HTM/TB/2013.2, World Health Organization, Geneva, Switzerland, 2013, http://apps.who.int/iris/bitstream/10665/79199/1/9789241505345eng.pdf.
Nabukenya-Mudiope MG, Kawuma HJ, Brouwer M, Mudiope P and Vassall A Tuberculosis retreatment ‘others’ in comparison with classical retreatment cases; a retrospective cohort review. BMC Public Health (2015) 15: 840.
Getnet F, Sileshi H, Seifu W, Yirga S and Alemu AS. Do retreatment tuberculosis patients need special treatment response follow-up beyond the standard regimen? Finding of five-year retrospective study in pastoralist setting. Getnet et al. BMC Infectious Diseases (2017) 17: 762.
Ouardi A, Hadjadj M, Bentata K and Berrabah Y. Analyse des résultats de traitement de la tuberculose multirésistante (TBMR) en fonction du régime thérapeutique prescrit. Rev Mal Respir. 2013; 30: A169.
Sharma SK, Mohan A. Directly observed treatment, short-course (DOTS). JIACM. 2004; 5 (2): 109–13.
E. Von Elm, D. G. Altman, M. Egger, S. J. Pocock, P. C. Gøtzsche and J. P. Vandenbroucke, The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370: 1453–1457.