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Trop Med Int Health. 2013 Nov;18(11):1386-91. doi: 10.1111/tmi.12183. Epub 2013 Sep 11.

Multidrug-resistant TB in Zambia: review of national data from 2000 to 2011.

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  • 1Ministry of Health, Lusaka, Zambia; National TB and Leprosy Control Programme, Ministry of Health, Lusaka, Zambia; University of Zambia-University College London Medical School Research and Training Programme, Lusaka, Zambia; Center for Tropical Medicine and Travel Medicine, University of Amsterdam, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

Multidrug-resistant tuberculosis (MDR-TB) is posing a great threat to global TB control. The burden in Zambia is not well defined because routine surveillance data are scarce. We reviewed national MDR-TB data for the last decade to inform future public health policy with respect to MDR-TB in Zambia.

METHOD:

Retrospective review of national surveillance of MDR-TB data, TB programme and laboratory reports between 2000 and 2011.

RESULTS:

The total number of DSTs performed during this 11-year period was 2,038 and accounted for 2.6% (2,038/78,639) of all the retreatment cases notified. The total number of diagnosed MDR-TB cases for this period was 446, of which 56.3% (251/446) were male and 41.7% (186/446) female. Only one child was found to have MDR-TB. Poly-drug resistance accounted for 18.9% (172/911) of the DR-TB cases and 8.4% of the total DSTs. 8.8% (80/911) of the DR-TB cases showed either rifampicin mono- or poly-resistance other than MDR-TB. No XDR-TB was reported. There were no data available on DR-TB and HIV co-infection. Only 65 MDR-TB patients were notified and put on second-line treatment according to WHO guidelines.

CONCLUSIONS:

Multidrug-resistant tuberculosis may be an emerging challenge in Zambia. There is a need to invest in improving the capacity of the TB programme to detect and manage MDR-TB.

© 2013 John Wiley & Sons Ltd.

KEYWORDS:

Zambia; diagnosis; multidrug-resistant tuberculosis; retreatments; surveillance; tuberculosis

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