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Int J Tuberc Lung Dis. 2015 Feb;19(2):151-6. doi: 10.5588/ijtld.14.0200.

Anti-tuberculosis drug resistance in Bangladesh: reflections from the first nationwide survey.

Author information

1
National Tuberculosis Reference Laboratory, National Institute of Diseases of the Chest and Hospital (NIDCH), Dhaka, Bangladesh.
2
National TB Programme, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh.
3
National Professional Offices-World Health Organization (NPO-WHO), Dhaka, Bangladesh.
4
NPO-WHO, TB CARE-II, Dhaka, Bangladesh.
5
Tuberculosis CARE-II, University Research Company, Dhaka, Bangladesh.
6
Bangladesh Unnayan Parishad (BUP), Dhaka, Bangladesh.
7
WHO South East Asia Regional Office, New Delhi, India.
8
Department of Microbiology, University of Dhaka, Dhaka, Bangladesh.
9
Damien Foundation, Dhaka, Bangladesh.
10
BRAC, Dhaka, Bangladesh.
11
NIDCH, Dhaka, Bangladesh.
12
Institute of Tropical Medicine, Antwerp, Belgium.

Erratum in

  • Int J Tuberc Lung Dis. 2015 May;19(5):622. Chowdhury, R A [corrected to Ahsan, Chowdhury R].

Abstract

OBJECTIVE:

To determine the prevalence of tuberculosis (TB) drug resistance in Bangladesh.

DESIGN:

Weighted cluster sampling among smear-positive cases, and standard culture and drug susceptibility testing on solid medium were used.

RESULTS:

Of 1480 patients enrolled during 2011, 12 falsified multidrug-resistant TB (MDR-TB) patients were excluded. Analysis included 1340 cases (90.5% of those enrolled) with valid results and known treatment antecedents. Of 1049 new cases, 12.3% (95%CI 9.3-16.1) had strains resistant to any of the first-line drugs tested, and 1.4% (95%CI 0.7-2.5) were MDR-TB. Among the 291 previously treated cases, this was respectively 43.2% (95%CI 37.1-49.5) and 28.5% (95%CI 23.5-34.1). History of previous anti-tuberculosis treatment was the only predictive factor for first-line drug resistance (OR 34.9). Among the MDR-TB patients, 19.2% (95%CI 11.3-30.5; exclusively previously treated) also showed resistance to ofloxacin. Resistance to kanamycin was not detected.

CONCLUSION:

Although MDR-TB prevalence was relatively low, transmission of MDR-TB may be increasing in Bangladesh. MDR-TB with fluoroquinolone resistance is rapidly rising. Integrating the private sector should be made high priority given the excessive proportion of MDR-TB retreatment cases in large cities. TB control programmes and donors should avoid applying undue pressure towards meeting global targets, which can lead to corruption of data even in national surveys.

PMID:
25574912
DOI:
10.5588/ijtld.14.0200
[Indexed for MEDLINE]

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