Fourth National Anti-Tuberculosis Drug Resistance Survey in Côte d'Ivoire Incorporating Sequencing
Abstract
BACKGROUND: Drug-resistant tuberculosis (TB) hinders global TB control. Rifampicin-resistant TB (RR-TB) prevalence, in Côte d'Ivoire, was 4.6% (95% confidence interval [95% CI]: 2.4-6.7) for new cases and 22% (95% CI: 13.7-30.3) with retreatment cases in 2016. The TB drug resistance survey (DRS) conducted in 2023 aimed to determine the updated prevalence of resistance among new, previously treated TB cases and to characterize the genotypes of circulating Mycobacterium tuberculosis strains.
METHODS: A nationwide, cluster-based cross-sectional DRS was conducted in a 6-month timeframe in 44 health facilities across the country, grouped into 45 clusters according to the World Health Organization guidance. Bacteriologically confirmed pulmonary TB cases were recruited after giving informed consent. Xpert ® MTB/RIF Ultra, Hain MTBDR plus and MTBDR sl were carried out on sputum samples. All samples with resistance detected and 10% of rifampicin (RIF) susceptible TB cases were cultured in liquid medium with Mycobacterium growth incubator tube (MGIT) (MGIT 960). Phenotypic drug susceptibility testing was performed for isoniazid (INH), RIF, amikacin (AMK), moxifloxacin, levofloxacin, clofazimine, bedaquiline, and linezolid. Whole-genome or targeted next-generation sequencing was conducted on 120 selected drug-resistant and susceptible strains. KoboCollect v2013.1.2 was used for data collection and storage. For statistical and cluster analysis, STATA 19.5 and core genome multilocus…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 1,024 participants or records.
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