Primary drug resistance in newly diagnosed smear positive tuberculosis patients in Addis Ababa, Ethiopia

Ethiop Med J. 2008 Oct;46(4):367-74.

Abstract

Background: Drug resistance monitoring is an important aspect of tuberculosis (TB) control.

Objective: To determine the sensitivity of mycobacterial isolates from newly diagnosed pulmonary TB patients to first line anti-TB drugs in Addis Ababa.

Methods: A survey on primary anti-tuberculosis drug resistance was conducted on smear positive pulmonary TB patients visiting 19 health centers and 3 hospitals in Addis Ababa from September 2004 to December 2005. Sputum was digested and decontaminated using Petroff's method and inoculated on Lowenstein-Jensen (LJ) media. Mycobacterial isolates were tested for sensitivity to isoniazid, rifampicin, ethambutol and streptomycin on Middlebrook 7H10 media using the standard indirect proportion method.

Results: Among the M. tuberculosis strains isolated from 173 patients, 21.4% were resistant to at least one drug. Single drug resistance to streptomycin was observed in 16.2%, to isoniazid in 13.3%, to rifampicin in 1.2% and to ethambutol in 3.5% of the isolates. The prevalence of resistance to at least one drug was 15.7% and 23.7% among patients with and without HIV co-infection, respectively (p > 0.05). Only one patient (0.6%) had a multidrug resistant (MDR) strain. However, the prevalence of resistance to more than one drug was 10.4%.

Conclusion: Although the prevalence of MDR was low in this study, the precursors of MDR are accumulating in Addis Ababa.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / pharmacology*
  • Antitubercular Agents / therapeutic use
  • Cross-Sectional Studies
  • Ethiopia / epidemiology
  • Female
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mycobacterium tuberculosis / drug effects*
  • Prevalence
  • Sputum / microbiology
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / epidemiology
  • Tuberculosis, Pulmonary / microbiology*
  • Young Adult

Substances

  • Antitubercular Agents