| Peer-Reviewed

Antituberculosis Drugs Resistance and Treatment Outcomes Among Retreatment Patients in Guinea: A Five-Year Retrospective Cohort Study

Received: 9 September 2019     Accepted: 24 September 2019     Published: 11 October 2019
Views:       Downloads:
Abstract

Tuberculosis (TB) is a global outbreak whose drug resistance is a constant threat. This study aimed at describing anti-TB drugs resistance and treatment outcomes among retreatment TB patients in Guinea between 2008 and 2012. We conducted a retrospective cohort study with a sample of 558 patients aged of at least 10, who were admitted for TB retreatment and who were tested for anti-TB drugs susceptibility during the study period. Overall, 3187 retreatment TB patients were recorded from January 1, 2008 to December 31, 2012 in Guinea, of which 558 (17.5%) performed susceptibility testing to anti-TB drugs. We found overall resistance in 417 cases (74.7%) including 356 (85.4%) of multidrug resistance (MDR), 29 (6.9%) of monoresistance (isoniazid 2.9%, streptomycin 2.9%, rifampicin 0.9%, ethambutol 0.2%) and 32 (7.7% of polydrug resistance (isoniazid + streptomycin 4.3%, rifampicin + streptomycin 1.4%, isoniazid + ethambutol + streptomycin 1.0%, rifampicin + ethambutol + streptomycin 1.0%). Most of the patients (84.6%) with anti-TB drugs resistance were under 45 and labourers were mostly represented (27.8%) including drivers in majority (37.9%). MDR-TB incidence rate increased by 12.2% between 2008 (65.6%) and 2012 (77.8%), and the annual cure rate decreased gradually from 60.0% in 2009 to 45.7% in 2012. Among MDR-TB patients (n= 356), only 112 (31.5%) benefited from second-line treatment regimen, of which, 51.7% were cured, 6.3% completed treatment, 24.1% died, 6.3% were lost to follow-up and 11.6% were not evaluated. The cure rate was higher in HIV-negative patients (55.3%) than in those who were HIV-positive (35.3%) and the death rate was the highest (41.2%) in HIV-positive patients. Overall, treatment success rate was 58.0%. This study revealed a low rate of performing drug susceptibility testing, the gradual increase of the incidence of MDR-TB each year and the gradual decrease of cure rate from year to year. Besides, anti-TB drugs resistance concerned mostly drivers in our context. Prospective studies are needed for a deep understanding of the factors associated with these persistent challenges.

Published in Science Journal of Public Health (Volume 7, Issue 5)
DOI 10.11648/j.sjph.20190705.16
Page(s) 167-173
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Antituberculosis, Resistance, Treatment Outcome, Retreatment Patients, Guinea

References
[1] Organisation Mondiale de la Santé (OMS). Mettre fin à la tuberculose d’ici 2030: cadre pour la mise en œuvre de la “stratégie de l’OMS pour mettre fin a la tuberculose” dans la région africaine au cours de la période 2016 – 2020. OMS, Bureau régional de l’Afrique. 2017.
[2] World Health Organization, Global Tuberculosis Report 2018, WHO/CDS/TB/2018.20. World Health Organization, Geneva, Switzerland, 2018. Available at: https://www.who.int/tb/publications/global_report/en/; Accessed on August 16, 2019.
[3] Organisation Mondiale de la Santé, Rapport sur la lutte contre la tuberculose dans le monde en 2017: Résumé d’orientation. Génève, 2017.
[4] Meyssonnier V. Epidémiologie de la tuberculose et de la résistance aux antituberculeux. Université Pierre et Marie Curie-Paris VI; 2012 [cited 2016 May 19]. Available from: https://tel.archives-ouvertes.fr/tel-00833269/
[5] Organisation Mondiale de la Santé. Tuberculose (TB): Impact mondial de la tuberculose. OMS, Bureau régional de l’Afrique. 2017
[6] World Health Assembly. Resolution A67/11. United Nations. 2014.
[7] Organisation Mondiale de la Santé (OMS). Rapport sur la lutte contre la tuberculose dans le monde. OMS, Genève, 2013. Google Sch.
[8] World Health Assembly. Resolution A/RES/71/4. United Nations. 2018. Available at: http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_4-en.pdf?ua=1
[9] OMS Rapport sur la lutte contre la tuberculose dans le monde. 2011. WHO/HTM/TB/2011.16. Disponible sur (dernier accès: 05; 2012).
[10] Veziris N, Jarlier V and Robert J. La résistance aux antituberculeux en France en 2009 2010. Bull Épidemiologique Hebdomadair. 2012; 24: 25.
[11] Veziris N and Robert J. Résistance aux antituberculeux et impasse thérapeutique. MS Médecine Sci. 2010; 26 (11): 976–80.
[12] Ade S, Adjibodé O, Wachinou P, Toundoh N, Awanou B and Agodokpessi G. Characteristics and Treatment Outcomes of Retreatment Tuberculosis Patients in Benin. Hindawi Publishing Corporation Tuberculosis Research and Treatment Volume 2016, Article ID 1468631, 7 pages http://dx.doi.org/10.1155/2016/1468631
[13] Sangaré L, Diandé S, Badoum G, Dingtoumda B and Traoré AS. Résistance aux antituberculeux chez les cas de tuberculose pulmonaire nouveaux ou traités antérieurement au Burkina Faso. Int J Tuberc Lung Dis. 2010; 14 (11): 1424–9.
[14] World Health Organization. Global tuberculosis report 2015. Geneva, Switzerland: World Health Organization; 2015.
[15] Ministère de la Santé. Guide de prise en charge de la tuberculose pharmacorésistante en Guinée. PNLAT; 2012.
[16] Institut National de la Statistique, Récensement Général de la Population et de l'Habitation (RGPH). Guinée: Institut National de la Statistique. Avril 2014. Available at: http://www.ins.ci/n/documents/RGPH2014_expo_dg.pdf. Accessed on: 15th April 2018.
[17] World Health Organization, “Definitions and reporting framework for tuberculosis_2013 revision,” Tech. Rep.WHO/HTM/TB/2013.2, World Health Organization, Geneva, Switzerland, 2013, http://apps.who.int/iris/bitstream/10665/79199/1/9789241505345eng.pdf.
[18] Nabukenya-Mudiope MG, Kawuma HJ, Brouwer M, Mudiope P and Vassall A Tuberculosis retreatment ‘others’ in comparison with classical retreatment cases; a retrospective cohort review. BMC Public Health (2015) 15: 840.
[19] Getnet F, Sileshi H, Seifu W, Yirga S and Alemu AS. Do retreatment tuberculosis patients need special treatment response follow-up beyond the standard regimen? Finding of five-year retrospective study in pastoralist setting. Getnet et al. BMC Infectious Diseases (2017) 17: 762.
[20] Ouardi A, Hadjadj M, Bentata K and Berrabah Y. Analyse des résultats de traitement de la tuberculose multirésistante (TBMR) en fonction du régime thérapeutique prescrit. Rev Mal Respir. 2013; 30: A169.
[21] Sharma SK, Mohan A. Directly observed treatment, short-course (DOTS). JIACM. 2004; 5 (2): 109–13.
[22] E. Von Elm, D. G. Altman, M. Egger, S. J. Pocock, P. C. Gøtzsche and J. P. Vandenbroucke, The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370: 1453–1457.
Cite This Article
  • APA Style

    Tamba Kallas Tonguino, Tamba Mina Millimouno, Boubacar Djelo Diallo, Alexandre Delamou, Nimer Ortuno Gutierrez, et al. (2019). Antituberculosis Drugs Resistance and Treatment Outcomes Among Retreatment Patients in Guinea: A Five-Year Retrospective Cohort Study. Science Journal of Public Health, 7(5), 167-173. https://doi.org/10.11648/j.sjph.20190705.16

    Copy | Download

    ACS Style

    Tamba Kallas Tonguino; Tamba Mina Millimouno; Boubacar Djelo Diallo; Alexandre Delamou; Nimer Ortuno Gutierrez, et al. Antituberculosis Drugs Resistance and Treatment Outcomes Among Retreatment Patients in Guinea: A Five-Year Retrospective Cohort Study. Sci. J. Public Health 2019, 7(5), 167-173. doi: 10.11648/j.sjph.20190705.16

    Copy | Download

    AMA Style

    Tamba Kallas Tonguino, Tamba Mina Millimouno, Boubacar Djelo Diallo, Alexandre Delamou, Nimer Ortuno Gutierrez, et al. Antituberculosis Drugs Resistance and Treatment Outcomes Among Retreatment Patients in Guinea: A Five-Year Retrospective Cohort Study. Sci J Public Health. 2019;7(5):167-173. doi: 10.11648/j.sjph.20190705.16

    Copy | Download

  • @article{10.11648/j.sjph.20190705.16,
      author = {Tamba Kallas Tonguino and Tamba Mina Millimouno and Boubacar Djelo Diallo and Alexandre Delamou and Nimer Ortuno Gutierrez and Mory Camara and Boubacar Bah and Oumou Younoussa Sow},
      title = {Antituberculosis Drugs Resistance and Treatment Outcomes Among Retreatment Patients in Guinea: A Five-Year Retrospective Cohort Study},
      journal = {Science Journal of Public Health},
      volume = {7},
      number = {5},
      pages = {167-173},
      doi = {10.11648/j.sjph.20190705.16},
      url = {https://doi.org/10.11648/j.sjph.20190705.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20190705.16},
      abstract = {Tuberculosis (TB) is a global outbreak whose drug resistance is a constant threat. This study aimed at describing anti-TB drugs resistance and treatment outcomes among retreatment TB patients in Guinea between 2008 and 2012. We conducted a retrospective cohort study with a sample of 558 patients aged of at least 10, who were admitted for TB retreatment and who were tested for anti-TB drugs susceptibility during the study period. Overall, 3187 retreatment TB patients were recorded from January 1, 2008 to December 31, 2012 in Guinea, of which 558 (17.5%) performed susceptibility testing to anti-TB drugs. We found overall resistance in 417 cases (74.7%) including 356 (85.4%) of multidrug resistance (MDR), 29 (6.9%) of monoresistance (isoniazid 2.9%, streptomycin 2.9%, rifampicin 0.9%, ethambutol 0.2%) and 32 (7.7% of polydrug resistance (isoniazid + streptomycin 4.3%, rifampicin + streptomycin 1.4%, isoniazid + ethambutol + streptomycin 1.0%, rifampicin + ethambutol + streptomycin 1.0%). Most of the patients (84.6%) with anti-TB drugs resistance were under 45 and labourers were mostly represented (27.8%) including drivers in majority (37.9%). MDR-TB incidence rate increased by 12.2% between 2008 (65.6%) and 2012 (77.8%), and the annual cure rate decreased gradually from 60.0% in 2009 to 45.7% in 2012. Among MDR-TB patients (n= 356), only 112 (31.5%) benefited from second-line treatment regimen, of which, 51.7% were cured, 6.3% completed treatment, 24.1% died, 6.3% were lost to follow-up and 11.6% were not evaluated. The cure rate was higher in HIV-negative patients (55.3%) than in those who were HIV-positive (35.3%) and the death rate was the highest (41.2%) in HIV-positive patients. Overall, treatment success rate was 58.0%. This study revealed a low rate of performing drug susceptibility testing, the gradual increase of the incidence of MDR-TB each year and the gradual decrease of cure rate from year to year. Besides, anti-TB drugs resistance concerned mostly drivers in our context. Prospective studies are needed for a deep understanding of the factors associated with these persistent challenges.},
     year = {2019}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Antituberculosis Drugs Resistance and Treatment Outcomes Among Retreatment Patients in Guinea: A Five-Year Retrospective Cohort Study
    AU  - Tamba Kallas Tonguino
    AU  - Tamba Mina Millimouno
    AU  - Boubacar Djelo Diallo
    AU  - Alexandre Delamou
    AU  - Nimer Ortuno Gutierrez
    AU  - Mory Camara
    AU  - Boubacar Bah
    AU  - Oumou Younoussa Sow
    Y1  - 2019/10/11
    PY  - 2019
    N1  - https://doi.org/10.11648/j.sjph.20190705.16
    DO  - 10.11648/j.sjph.20190705.16
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 167
    EP  - 173
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20190705.16
    AB  - Tuberculosis (TB) is a global outbreak whose drug resistance is a constant threat. This study aimed at describing anti-TB drugs resistance and treatment outcomes among retreatment TB patients in Guinea between 2008 and 2012. We conducted a retrospective cohort study with a sample of 558 patients aged of at least 10, who were admitted for TB retreatment and who were tested for anti-TB drugs susceptibility during the study period. Overall, 3187 retreatment TB patients were recorded from January 1, 2008 to December 31, 2012 in Guinea, of which 558 (17.5%) performed susceptibility testing to anti-TB drugs. We found overall resistance in 417 cases (74.7%) including 356 (85.4%) of multidrug resistance (MDR), 29 (6.9%) of monoresistance (isoniazid 2.9%, streptomycin 2.9%, rifampicin 0.9%, ethambutol 0.2%) and 32 (7.7% of polydrug resistance (isoniazid + streptomycin 4.3%, rifampicin + streptomycin 1.4%, isoniazid + ethambutol + streptomycin 1.0%, rifampicin + ethambutol + streptomycin 1.0%). Most of the patients (84.6%) with anti-TB drugs resistance were under 45 and labourers were mostly represented (27.8%) including drivers in majority (37.9%). MDR-TB incidence rate increased by 12.2% between 2008 (65.6%) and 2012 (77.8%), and the annual cure rate decreased gradually from 60.0% in 2009 to 45.7% in 2012. Among MDR-TB patients (n= 356), only 112 (31.5%) benefited from second-line treatment regimen, of which, 51.7% were cured, 6.3% completed treatment, 24.1% died, 6.3% were lost to follow-up and 11.6% were not evaluated. The cure rate was higher in HIV-negative patients (55.3%) than in those who were HIV-positive (35.3%) and the death rate was the highest (41.2%) in HIV-positive patients. Overall, treatment success rate was 58.0%. This study revealed a low rate of performing drug susceptibility testing, the gradual increase of the incidence of MDR-TB each year and the gradual decrease of cure rate from year to year. Besides, anti-TB drugs resistance concerned mostly drivers in our context. Prospective studies are needed for a deep understanding of the factors associated with these persistent challenges.
    VL  - 7
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Research Unit, National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea

  • Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Research Unit, National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea

  • Tuberculosis Control Project, Action Damien, Conakry, Guinea

  • Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Sections