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

S M M Kamal; A Hossain; S Sultana; V Begum; N Haque; J Ahmed; T M A Rahman; K A Hyder; S Hossain; M Rahman; Chowdhury R Ahsan; R A Chowdhury; K J M Aung; A Islam; R Hasan; A Van Deun

doi:10.5588/ijtld.14.0200

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

S M M Kamal, A Hossain, S Sultana, V Begum, N Haque, J Ahmed, T M A Rahman, K A Hyder, S Hossain, M Rahman, Chowdhury R Ahsan, R A Chowdhury, K J M Aung, A Islam, R Hasan, A Van Deun

Mycobacteriology

Research output: Contribution to journal › A1: Web of Science-article › peer-review

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.

Original language	English
Journal	International Journal of Tuberculosis and Lung Disease
Volume	19
Issue number	2
Pages (from-to)	151-156
Number of pages	6
ISSN	1027-3719
DOIs	https://doi.org/10.5588/ijtld.14.0200
Publication status	Published - 2015

Keywords

Adolescent
Adult
Aged
Antitubercular Agents
Bangladesh
Cross-Sectional Studies
Drug Resistance, Multiple, Bacterial
Female
Fluoroquinolones
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Mycobacterium tuberculosis
Prevalence
Sputum
Tuberculosis, Multidrug-Resistant
Young Adult

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10.5588/ijtld.14.0200

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Kamal, S. M. M., Hossain, A., Sultana, S., Begum, V., Haque, N., Ahmed, J., Rahman, T. M. A., Hyder, K. A., Hossain, S., Rahman, M., Ahsan, C. R., Chowdhury, R. A., Aung, K. J. M., Islam, A., Hasan, R., & Van Deun, A. (2015). Anti-tuberculosis drug resistance in Bangladesh: reflections from the first nationwide survey. International Journal of Tuberculosis and Lung Disease, 19(2), 151-156. https://doi.org/10.5588/ijtld.14.0200

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title = "Anti-tuberculosis drug resistance in Bangladesh: reflections from the first nationwide survey",

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.",

keywords = "Adolescent, Adult, Aged, Antitubercular Agents, Bangladesh, Cross-Sectional Studies, Drug Resistance, Multiple, Bacterial, Female, Fluoroquinolones, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Mycobacterium tuberculosis, Prevalence, Sputum, Tuberculosis, Multidrug-Resistant, Young Adult",

author = "Kamal, {S M M} and A Hossain and S Sultana and V Begum and N Haque and J Ahmed and Rahman, {T M A} and Hyder, {K A} and S Hossain and M Rahman and Ahsan, {Chowdhury R} and Chowdhury, {R A} and Aung, {K J M} and A Islam and R Hasan and {Van Deun}, A",

year = "2015",

doi = "10.5588/ijtld.14.0200",

language = "English",

volume = "19",

pages = "151--156",

journal = "International Journal of Tuberculosis and Lung Disease",

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publisher = "International Union Against Tuberculosis and Lung Disease",

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Kamal, SMM, Hossain, A, Sultana, S, Begum, V, Haque, N, Ahmed, J, Rahman, TMA, Hyder, KA, Hossain, S, Rahman, M, Ahsan, CR, Chowdhury, RA, Aung, KJM, Islam, A, Hasan, R & Van Deun, A 2015, 'Anti-tuberculosis drug resistance in Bangladesh: reflections from the first nationwide survey', International Journal of Tuberculosis and Lung Disease, vol. 19, no. 2, pp. 151-156. https://doi.org/10.5588/ijtld.14.0200

TY - JOUR

T1 - Anti-tuberculosis drug resistance in Bangladesh

T2 - reflections from the first nationwide survey

AU - Kamal, S M M

AU - Hossain, A

AU - Sultana, S

AU - Begum, V

AU - Haque, N

AU - Ahmed, J

AU - Rahman, T M A

AU - Hyder, K A

AU - Hossain, S

AU - Rahman, M

AU - Ahsan, Chowdhury R

AU - Chowdhury, R A

AU - Aung, K J M

AU - Islam, A

AU - Hasan, R

AU - Van Deun, A

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Aged

KW - Antitubercular Agents

KW - Bangladesh

KW - Cross-Sectional Studies

KW - Drug Resistance, Multiple, Bacterial

KW - Female

KW - Fluoroquinolones

KW - Humans

KW - Male

KW - Microbial Sensitivity Tests

KW - Middle Aged

KW - Mycobacterium tuberculosis

KW - Prevalence

KW - Sputum

KW - Tuberculosis, Multidrug-Resistant

KW - Young Adult

U2 - 10.5588/ijtld.14.0200

DO - 10.5588/ijtld.14.0200

M3 - A1: Web of Science-article

C2 - 25574912

SN - 1027-3719

VL - 19

SP - 151

EP - 156

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

IS - 2

ER -

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

Abstract

Keywords

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