The Contribution of the Xpert<sup>®</sup> MTB/RIF Assay to the Surveillance of Drug-Resistant Tuberculosis in the Central African Republic
The Contribution of the Xpert<sup>®</sup> MTB/RIF Assay to the Surveillance of Drug-Resistant Tuberculosis in the Central African Republic作者机构：National Reference Laboratory for Tuberculosis Institut Pasteur of Bangui Bangui Central African Republic Faculty of Health Sciences University of Bangui Bangui Central African Republic Medical Laboratory Institute Pasteur of Bangui Bangui Central African Republic Epidemiology Unit Institute Pasteur of Bangui Bangui Central African Republic
出 版 物：《Journal of Tuberculosis Research》 (结核病研究（英文）)
年 卷 期：2023年第11卷第1期
页 面：23-32页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
主 题：Xpert® MTB/RIF Assay Rifampicin Surveillance CAR
摘 要：Introduction: The Central African Republic is one of the 30 high Tuberculosis burden countries in the world, with an incidence of 540 cases per 100,000 population and a mortality of 91 deaths per 100,000 population. Since 2020, following WHO recommendations, the National Reference Laboratory for Tuberculosis has been using the Xpert® MTB/RIF assay as a first-line diagnostic test for the early detection of Drug Resistance Tuberculosis. The goal of this study was to evaluate the contribution of the Xpert® MTB/RIF assay to the surveillance of rifampicin resistance in new and previously treated tuberculosis cases. Materials and Methods: The data relative to the Xpert® MTB/RIF assay carried out on various categories of tuberculosis patients registered at the National Reference Laboratory for Tuberculosis in 2020 were analyzed retrospectively. The categories of tuberculosis patients were new cases, failed treatment cases, relapse cases, lost-to-follow-up cases and multidrug-resistant tuberculosis contact cases. Results: A total of 1404 tuberculosis patients were registered at the NRL-TB in 2020;the mean age was 39.2 years (2 - 90 years) and the male-to-female sex ratio was 1.16:1. Overall, 32.7% (454/1404) proved infected with tuberculosis, of which 22.5% (102/454) cases showed resistance to rifampicin. The primary resistance rate was 9.1% (27/298) and the secondary resistance rate was 46.6% (75/161). Treatment failures and relapsed cases were significantly associated with rifampicin resistance (p 0.005). Conclusion: Large-scale use of Xpert® MTB/RIF, especially in the provinces of the Central African Republic, will help the Ministry of Health to better control Drug Resistance Tuberculosis in the country.
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