Diandé Souba, Badoum Gisèle, Combary Adjima, Zombra Issaka, Saouadogo Tandaogo, Sawadogo Léon T, Nébié Bayéma, Gnanou Saïdou, Zigani Adama, Ouédraogo Seydou Mohamed, Diallo Adama, Kaboré Seydou, Sangaré Lassana
Programme National de Lutte contre la Tuberculose, Ministère de la Santé, Ouagadougou, Burkina Faso.
Université Ouaga-I Pr Joseph Ki-Zerbo, Unité de Formation en Sciences de la Santé, Ouagadougou, Burkina Faso.
Eur J Microbiol Immunol (Bp). 2019 Feb 6;9(1):23-28. doi: 10.1556/1886.2018.00029. eCollection 2019 Mar 18.
A survey of the prevalence of drug-resistant tuberculosis (DR-TB) in new and previously treated patients (PTPs) was performed in Burkina Faso from 2016 to 2017.
In this cross-sectional survey, a structured questionnaire was administered to eligible smear-positive patients in all 86 diagnostic and treatment centers of the country to collect their socio-demographic characteristics and medical histories. Their sputa were tested using the (MTB/RIF) Xpert assay. Those which were found to be positive for TB and rifampicin-resistant were also tested with GenoType MTBDRplus2.0 and MTBDRsl2.0. Univariate and multivariate logistic regressions were performed to determine risk factors associated with rifampicin resistance.
Of the 1140 smear-positive patients enrolled, 995 new and 145 PTPs were positive for MTB complex by Xpert. Of these, 2.0% (20/995, 95% confidence interval (CI): 1.1-2.9) of the new cases and 14.5% (95% CI: 14.2-20.2) of the PTPs were resistant to rifampicin; 83% of them has multidrug-resistant tuberculosis (MDR-TB). None were pre-extensively drug-resistant TB (pre-XDR-TB) or XDR-TB. Only the previous treatment was significantly associated with rifampicin resistance, < 0.0001.
Similar to global trends, rifampicin resistance was significantly higher in patients with prior TB treatment (14.5%) than in naïve patients (2.0%). These percentages are slightly below the global averages, but nonetheless suggest the need for continued vigilance. Extending the use of Xpert testing should strengthen the surveillance of DR-TB in Burkina Faso.
2016年至2017年在布基纳法索对新发病患者和既往治疗患者（PTPs）中的耐多药结核病（DR-TB）患病率进行了一项调查。
在这项横断面调查中，对该国所有86个诊断和治疗中心符合条件的涂片阳性患者进行了结构化问卷调查，以收集他们的社会人口统计学特征和病史。使用Xpert（MTB/RIF）检测法对他们的痰液进行检测。对那些被发现结核和利福平耐药呈阳性的样本，还使用GenoType MTBDRplus2.0和MTBDRsl2.0进行检测。进行单因素和多因素逻辑回归以确定与利福平耐药相关的危险因素。
在纳入的1140例涂片阳性患者中，995例新发病患者和145例既往治疗患者的Xpert检测MTB复合群呈阳性。其中，新发病例中有2.0%（20/995，95%置信区间（CI）：1.1 - 2.9）、既往治疗患者中有14.5%（95% CI：14.2 - 20.2）对利福平耐药；其中83%患有耐多药结核病（MDR-TB）。无一例为广泛耐药结核病前期（pre-XDR-TB）或广泛耐药结核病（XDR-TB）。仅既往治疗与利福平耐药显著相关，P<0.0001。
与全球趋势相似，既往接受过结核病治疗的患者（14.5%）的利福平耐药率显著高于初治患者（2.0%）。这些百分比略低于全球平均水平，但仍表明需要持续保持警惕。扩大Xpert检测的使用应加强布基纳法索对DR-TB的监测。
