Rise in rifampicin-monoresistant tuberculosis in Western Cape, South Africa

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dc.contributor.authorMukinda, Fidele K.en_ZA
dc.contributor.authorTheron D.
dc.contributor.authorVan Der Spuy G.D.
dc.contributor.authorJacobson K.R.
dc.contributor.authorRoscher M.
dc.contributor.authorStreicher E.M.
dc.contributor.authorMusekiwa A.
dc.contributor.authorCoetzee G.J.
dc.contributor.authorVictor T.C.
dc.contributor.authorMarais B.J.
dc.contributor.authorNachega J.B.
dc.contributor.authorWarren R.M.
dc.contributor.authorSchaaf H.S.
dc.date.accessioned2012-02-15T08:18:35Z
dc.date.available2012-02-15T08:18:35Z
dc.date.issued2012
dc.description.abstractSETTING: Brewelskloof Hospital, Western Cape, South Africa. OBJECTIVES: To verify the perceived increase in rifampicin monoresistant tuberculosis (RMR-TB) in the Cape Winelands-Overberg region and to identify potential risk factors. DESIGN: A retrospective descriptive study of trends in RMR-TB over a 5-year period (2004-2008), followed by a case-control study of RMR and isoniazid (INH) monoresistant TB cases, diagnosed from April 2007 to March 2009, to assess for risk factors. RESULTS: The total number of RMR-TB cases more than tripled, from 31 in 2004 to 98 in 2008. The calculated doubling time was 1.63 years (95%CI 1.18-2.66). For the assessment of risk factors, 95 RMR-TB cases were objectively verified on genotypic and phenotypic analysis. Of 108 specimens genotypically identified as RMR cases, 13 (12%) were misidentified multidrugresistant TB. On multivariate analysis, previous use of antiretroviral therapy (OR 6.4, 95%CI 1.3-31.8), alcohol use (OR 4.8, 95%CI 2.0-11.3) and age ≥40 years (OR 5.8, 95%CI 2.4-13.6) were significantly associated with RMR-TB. CONCLUSION: RMR-TB is rapidly increasing in the study setting, particularly among patients with advanced human immunodeficiency virus (HIV) disease. Routine drug susceptibility testing should be considered in all TB-HIV co-infected patients, and absence of INH resistance should be confirmed phenotypically if genotypic RMR-TB is detected. © 2012 The Union.
dc.identifier.citationInternational Journal of Tuberculosis and Lung Disease
dc.identifier.citation16
dc.identifier.citation2
dc.identifier.citation196
dc.identifier.citation202
dc.identifier.issn10273719
dc.identifier.other10.5588/ijtld.11.0116
dc.identifier.urihttp://hdl.handle.net/10019.1/19760
dc.subjectantiretrovirus agent
dc.subjectisoniazid
dc.subjectrifampicin
dc.subjectadult
dc.subjectage
dc.subjectalcohol consumption
dc.subjectarticle
dc.subjectcase control study
dc.subjectcontrolled study
dc.subjectdescriptive research
dc.subjectdrug resistant tuberculosis
dc.subjectfemale
dc.subjectgenotype
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmixed infection
dc.subjectmultidrug resistant tuberculosis
dc.subjectMycobacterium tuberculosis
dc.subjectnonhuman
dc.subjectpriority journal
dc.subjectretrospective study
dc.subjectrisk factor
dc.subjectSouth Africa
dc.subjectsputum smear
dc.titleRise in rifampicin-monoresistant tuberculosis in Western Cape, South Africa
dc.typeArticle
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