scholarly journals Multidrug‐Resistant and Extensively Drug‐Resistant Tuberculosis: Implications for the HIV Epidemic and Antiretroviral Therapy Rollout in South Africa

2007 ◽  
Vol 196 (s3) ◽  
pp. S482-S490 ◽  
Author(s):  
Jason R. Andrews ◽  
N. Sarita Shah ◽  
Neel Gandhi ◽  
Tony Moll ◽  
Gerald Friedland ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Hiv Epidemic ◽  
Extensively Drug Resistant ◽  
Antiretroviral Therapy Rollout

scholarly journals Evolving rifampicin and isoniazid mono-resistance in a high multidrug-resistant and extensively drug-resistant tuberculosis region: a retrospective data analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031663
Author(s):  
Nomonde Ritta Mvelase ◽  
Yusentha Balakrishna ◽  
Keeren Lutchminarain ◽  
Koleka Mlisana
Keyword(s):  
South Africa ◽  
Diagnostic Algorithm ◽  
Multidrug Resistant ◽  
Continuous Phase ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Kwazulu Natal ◽  
Mdr Tb

ObjectivesSouth Africa ranks among the highest drug-resistant tuberculosis (DR-TB) burdened countries in the world. This study assessed the changes in resistance levels in culture confirmed Mycobacterium tuberculosis (MTB) in the highest burdened province of South Africa during a period where major changes in diagnostic algorithm were implemented.SettingThis study was conducted at the central academic laboratory of the KwaZulu-Natal province of South Africa.ParticipantsWe analysed data for all MTB cultures performed in the KwaZulu-Natal province between 2011 and 2014. The data were collected from the laboratory information system.ResultsOut of 88 559 drug susceptibility results analysed, 18 352 (20.7%) were resistant to rifampicin (RIF) and 19 190 (21.7%) showed resistance to isoniazid (INH). The proportion of rifampicin resistant cases that were mono-resistant increased from 15.3% in 2011 to 21.4% in 2014 while INH mono-resistance (IMR) showed a range between 13.8% and 21.1%. The multidrug-resistant tuberculosis (MDR-TB) rates increased from 18.8% to 23.9% and the proportion of MDR-TB cases that had extensively drug-resistant tuberculosis remained between 10.2% and 11.1%. Most drug resistance was found in females between the ages of 15 and 44 years and the northern districts bordering high MDR-TB regions had the highest MDR-TB rates.ConclusionOur findings show increasing RIF mono-resistance (RMR) and a substantial amount of IMR. This highlights a need for an initial test that detects resistance to both these drugs so as to avoid using RIF monotherapy during continuous phase of treatment in patients with IMR. Furthermore, addition of INH will benefit patients with RMR. Although DR-TB is widespread, HIV and migration influence its distribution; therefore, TB control strategies should include interventions that target these aspects.

scholarly journals Exogenous Reinfection as a Cause of Multidrug‐Resistant and Extensively Drug‐Resistant Tuberculosis in Rural South Africa

2008 ◽  
Vol 198 (11) ◽  
pp. 1582-1589 ◽  
Author(s):  
Jason R. Andrews ◽  
Neel R. Gandhi ◽  
Prashini Moodley ◽  
N. Sarita Shah ◽  
Louise Bohlken ◽  
...  
Keyword(s):  
South Africa ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Rural South ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Exogenous Reinfection ◽  
Rural South Africa

scholarly journals Programmatically Selected Multidrug-Resistant Strains Drive the Emergence of Extensively Drug-Resistant Tuberculosis in South Africa

PLoS ONE ◽  
2013 ◽  
Vol 8 (8) ◽  
pp. e70919 ◽  
Author(s):  
Borna Müller ◽  
Violet N. Chihota ◽  
Manormoney Pillay ◽  
Marisa Klopper ◽  
Elizabeth M. Streicher ◽  
...  
Keyword(s):  
South Africa ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Resistant Strains
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