Umubyeyi A N, Vandebriel G, Gasana M, Basinga P, Zawadi J P, Gatabazi J, Pauwels P, Nzabintwali F, Nyiramasarabwe L, Fissette K, Rigouts L, Struelens M J, Portaels F
National University of Rwanda, Butare, Rwanda.
Int J Tuberc Lung Dis. 2007 Feb;11(2):189-94.
One of the principal objectives of tuberculosis (TB) control is to minimise the emergence of drug resistance. The first national survey was conducted in Rwanda to determine the prevalence of M. tuberculosis drug resistance.
Sputum samples were collected from all new and retreatment cases in the health districts from November 2004 to February 2005. Drug susceptibility testing of isolates against first-line drugs was performed by the proportion method.
Of 616 strains from new cases, 6.2% were resistant to isoniazid, 3.9% to rifampicin and 3.9% were multidrug-resistant TB. Among 85 strains from previously treated cases, the prevalence of resistance was respectively 10.6%, 10.6% and 9.4% (MDR-TB strains). Eight MDR cases showed additional resistance to ethambutol and streptomycin.
The level of MDR-TB among TB patients in Rwanda is high. The main reasons of this emergence of MDR-TB can be attributed to the disorganisation of the health system, migration of the population during the 1994 civil war and poor success rates, with a high number of patients transferred out and lost to follow-up. On the other hand, the use of treatment regimens administered twice weekly during the continuation phase could be another important factor and merit further investigations.
结核病控制的主要目标之一是尽量减少耐药性的出现。卢旺达开展了首次全国性调查，以确定结核分枝杆菌耐药性的流行情况。
2004年11月至2005年2月期间，从各卫生区的所有新发病例和复治病例中采集痰液样本。采用比例法对分离株进行一线药物药敏试验。
在616株新发病例菌株中，6.2%对异烟肼耐药，3.9%对利福平耐药，3.9%为耐多药结核病。在85株既往治疗病例菌株中，耐药率分别为10.6%、10.6%和9.4%（耐多药结核菌株）。8例耐多药病例对乙胺丁醇和链霉素也有耐药。
卢旺达结核病患者中耐多药结核病水平较高。耐多药结核病出现的主要原因可归因于卫生系统的混乱、1994年内战期间的人口迁移以及治疗成功率低，大量患者转出且失访。另一方面，继续期采用每周两次给药方案可能是另一个重要因素，值得进一步研究。
