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Experience on the first national anti-TB drug resistance survey(DRS)in Timor-Leste

Global Health Research and Policy 2022年第1期7卷 415-423页

作者： Constantino Lopes Debashish Kundu Ismael Da Costa Barreto Bernardino da Cruz SSiva Kumar Sureshbabu Ramalingam Anna SDean Vineet Bhatia Prabhu Seenivasan CPadmapriyadarsini olga tosas auguet National TB Programme Ministry of HealthDiliTimor-Leste World Health Organization Country Office for Timor-Leste DiliTimor-Leste National Health Laboratory Ministry of HealthDiliTimor-Leste National HIV Programme Ministry of HealthDiliTimor-Leste National Institute for Research in Tuber-culosis ChennaiIndia National TB Reference Laboratory DiliTimor-Leste Global Tuberculosis Programme World Health OrganizationGenevaSwitzerland World Health Organization South East Asia Regional Office New DelhiIndia

Background:A national drug resistance survey(DRS)was implemented for the first time in Timor-Leste(TL)in *** primary objective of the survey was to assess the prevalence of drug resistance among new and previously treated pulmonary TB patients in the ***:This nation-wide cross-sectional survey was conducted in 2019 targeting all new and previously treated sputum smear-positive pulmonary TB *** samples were submitted to the National TB Reference Laboratory for confirmation of TB and to determine resistance to rifampicin by Xpert MTB/*** was performed on solid media,and culture isolates of confirmed TB cases were shipped to the WHO Supranational TB Reference Laboratory in Chennai,India for whole genome sequencing(WGS).Survey summary statistics,data cross-tabulations and analysis of potential risk factors of rifampicin-resistant TB(RR-TB)were conducted using R statistical software(version 3.5.2).Results:A total of 953 sputum-smear positive patients were enrolled,of which 917 were confirmed as positive for TB by either Xpert MTB/RIF or *** electronic web-based system was used for entry and storage of the *** resistance was detected among 0.6%(95%CI 0.2-1.3)of new cases and 2.7%(95%CI 0.5-8.2)of previously treated *** was conducted for validation purposes on 65 randomly selected isolates(29%of RR-TB(2/7)and 7%of RS-TB(63/910)by Xpert MTB/RIF or pDST).The original test results agreed with the WGS validation results for 62/64 isolates(97%).Conclusion:The prevalence of RR-TB in Timor-Leste is relatively low compared to the estimated proportions of RR-TB in the WHO South-East Asia Region(2.5%[95%CI 1.9-3.3]among new cases and 14%[95%CI 7.7-21]among previously treated cases).The rapid sputum collection and transportation mechanism implemented in the survey demonstrates its feasibility in low resource settings and should be replicated for routinely transporting TB specimens from microscopy labs to GeneXpert ***

关键词： Anti-TB Drug Resistance Survey Rifampicin resistance Whole genome sequencing Timor-Leste

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