Author:
Chisompola Namaunga Kasumu,Streicher Elizabeth Maria,Muchemwa Chishala Miriam Kapambwe,Warren Robin Mark,Sampson Samantha Leigh
Abstract
Abstract
Background
The burden of drug resistant tuberculosis in Africa is largely driven by the emergence and spread of multidrug resistant (MDR) and extensively drug resistant (XDR) Mycobacterium tuberculosis strains. MDR-TB is defined as resistance to isoniazid and rifampicin, while XDR-TB is defined as MDR-TB with added resistance to any of the second line injectable drugs and any fluoroquinolone.
The highest burden of drug resistant TB is seen in countries further experiencing an HIV epidemic. The molecular mechanisms of drug resistance as well as the evolution of drug resistant TB strains have been widely studied using various genotyping tools. The study aimed to analyse the drug resistant lineages in circulation and transmission dynamics of these lineages in Africa by describing outbreaks, nosocomial transmission and migration. Viewed as a whole, this can give a better insight into the transmission dynamics of drug resistant TB in Africa.
Methods
A systematic review was performed on peer reviewed original research extracted from PubMed reporting on the lineages associated with drug resistant TB from African countries, and their association with outbreaks, nosocomial transmission and migration. The search terms “Tuberculosis AND drug resistance AND Africa AND (spoligotyping OR molecular epidemiology OR IS6110 OR MIRU OR DNA fingerprinting OR RFLP OR VNTR OR WGS)” were used to identify relevant articles reporting the molecular epidemiology of drug resistant TB in Africa.
Results
Diverse genotypes are associated with drug resistant TB in Africa, with variations in strain predominance within the continent. Lineage 4 predominates across Africa demonstrating the ability of “modern strains” to adapt and spread easily. Most studies under review reported primary drug resistance as the predominant type of transmission. Drug resistant TB strains are associated with community and nosocomial outbreaks involving MDR- and XDR-TB strains. The under-use of molecular epidemiological tools is of concern, resulting in gaps in knowledge of the transmission dynamics of drug resistant TB on the continent.
Conclusions
Genetic diversity of M. tuberculosis strains has been demonstrated across Africa implying that diverse genotypes are driving the epidemiology of drug resistant TB across the continent.
Funder
National Research Foundation
Organization for Women in Science for the Developing World
Publisher
Springer Science and Business Media LLC
Reference102 articles.
1. World Health Organization. Global tuberculosis report. Geneva: WHO press; 2018.
2. World Health Organization. Treatment guidelines for multidrug- and rifampicin-resistant tuberculosis. 2018 update. Geneva: WHO press; 2018.
3. Aung KJ, Van Deun A, Declercq E, Sarker MR, Das PK, Hossain MA, Rieder HL. Successful ‘9-month Bangladesh regimen’ for multidrug-resistant tuberculosis among over 500 consecutive patients. Int J Tuberc Lung Dis. 2014;18:1180–7.
4. World Health Organization. The shorter MDR-TB regimen. Geneva: WHO press; 2016.
5. Menzies HJ, Moalosi G, Anisimova V, Gammino V, Sentle C, Bachhuber MA, et al. Increase in anti-tuberculosis drug resistance in Botswana: results from the fourth national drug resistance survey. Int J Tuberc Lung Dis. 2014;18(9):1026–33.
Cited by
19 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献