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Tuberculosis (Edinb). 2014 Jan;94(1):1-7. doi: 10.1016/j.tube.2013.08.009. Epub 2013 Sep 7.

Epidemiology and genetic diversity of multidrug-resistant tuberculosis in East Africa.

Author information

1
Department of Biochemistry and Molecular Biology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; Center for Global Health, Division of Infectious Diseases, Weill Cornell Medical College, New York, NY, United States of America. Electronic address: benkidenya@gmail.com.
2
Center for Global Health, Division of Infectious Diseases, Weill Cornell Medical College, New York, NY, United States of America.
3
Center for Global Health, Division of Infectious Diseases, Weill Cornell Medical College, New York, NY, United States of America; Department of Internal Medicine, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
4
Department of Microbiology and Immunology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
5
Center for Global Health, Division of Infectious Diseases, Weill Cornell Medical College, New York, NY, United States of America; Les Centres GHESKIO, Port-au-Prince, Haiti.

Abstract

Multidrug-resistant tuberculosis (MDR-TB) is an emerging problem in many parts of the world, and levels of MDR-TB among new TB patients are increasing in sub-Saharan Africa. We reviewed the prevalence and molecular epidemiology of MDR-TB in East Africa, including Burundi, Kenya, Rwanda, Tanzania, and Uganda. In 16 epidemiologic surveys, the prevalence of MDR among new cases ranges from 0.4% in Tanzania to 4.4% in Uganda, and among recurrent cases ranges from 3.9% in Tanzania to 17.7% in Uganda. There is a gap of 5948 cases between the estimated number of MDR-TB cases in East Africa and the number actually diagnosed. The only confirmed risk factors for MDR-TB are prior treatment for TB and refugee status. HIV has not been reported as a risk factor, and there are no reports of statistical association between spoligotype and drug resistance pattern. Increased capacity for diagnosis and treatment of MDR-TB is needed, with an emphasis on recurrent TB cases and refugees.

KEYWORDS:

East Africa; Genetic diversity; Multidrug-resistant tuberculosis (MDR-TB); Prevalence; Risk factors

PMID:
24215798
PMCID:
PMC3877177
DOI:
10.1016/j.tube.2013.08.009
[Indexed for MEDLINE]
Free PMC Article

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