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  • Title: Increase in anti-tuberculosis drug resistance in Botswana: results from the fourth National Drug Resistance Survey.
    Author: Menzies HJ, Moalosi G, Anisimova V, Gammino V, Sentle C, Bachhuber MA, Bile E, Radisowa K, Kachuwaire O, Basotli J, Maribe T, Makombe R, Shepherd J, Kim B, Samandari T, El-Halabi S, Chirenda J, Cain KP.
    Journal: Int J Tuberc Lung Dis; 2014 Sep; 18(9):1026-33. PubMed ID: 25189548.
    Abstract:
    SETTING: Although approximately 0.5 million cases of multidrug-resistant tuberculosis (MDR-TB) occur globally each year, surveillance data are limited. Botswana is one of the few high TB burden countries to have carried out multiple anti-tuberculosis drug resistance surveys (in 1995-1996, 1999 and 2002). OBJECTIVE: In 2007-2008, we conducted the fourth national survey of anti-tuberculosis drug resistance in Botswana to assess anti-tuberculosis drug resistance, including trends over time. In the previous survey, 0.8% (95%CI 0.4-1.5) of new patients and 10.4% (95%CI 5.6-17.3) of previously treated patients had MDR-TB. DESIGN: During the survey period, eligible specimens from all new sputum-smear positive TB patients and from all TB patients with history of previous anti-tuberculosis treatment underwent mycobacterial culture and anti-tuberculosis drug susceptibility testing (DST). RESULTS: Of 924 new TB patients and 137 with previous anti-tuberculosis treatment with DST results, respectively 23 (2.5%, 95%CI 1.6-3.7) and 9 (6.6%, 95%CI 3.3-11.7) had MDR-TB. The proportion of new TB patients with MDR-TB has tripled in Botswana since the previous survey. CONCLUSION: Combatting drug-resistant TB will require the scale-up of MDR-TB diagnosis and treatment to prevent the transmission of MDR-TB and strengthening of general TB control to prevent the emergence of resistance.
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