Drug-resistant TB prevalence study in 5 health institutions in Haiti

Tuberculosis (TB) is the leading infectious cause of death in the world. Multi-drug resistant TB (MDR-TB) is a major public health problem as treatment is long, costly, and associated to poor outcomes. Here, we report epidemiological data on the prevalence of drug-resistant TB in Haiti. This cross-s...

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Bibliographic Details
Published in:PloS one 2021-03, Vol.16 (3), p.e0248707-e0248707
Main Authors: Hoffmann, Jonathan, Chedid, Carole, Ocheretina, Oksana, Masetti, Chloé, Joseph, Patrice, Mabou, Marie-Marcelle, Mathon, Jean Edouard, Francois, Elie Maxime, Gebelin, Juliane, Babin, François-Xavier, Raskine, Laurent, Pape, Jean William
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Computer programs
Distribution
Drafting software
Drug resistance
Editing
Ethical standards
Extensively drug-resistant tuberculosis
Funding
Genetic aspects
HIV
Human immunodeficiency virus
Infectious diseases
Laboratories
Medicine and Health Sciences
Methodology
Microscopy
Patients
People and places
Physiological aspects
Population
Public health
Sociodemographics
Software
Tuberculosis
Variables
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Summary:Tuberculosis (TB) is the leading infectious cause of death in the world. Multi-drug resistant TB (MDR-TB) is a major public health problem as treatment is long, costly, and associated to poor outcomes. Here, we report epidemiological data on the prevalence of drug-resistant TB in Haiti. This cross-sectional prevalence study was conducted in five health centers across Haiti. Adult, microbiologically confirmed pulmonary TB patients were included. Molecular genotyping (rpoB gene sequencing and spoligotyping) and phenotypic drug susceptibility testing were used to characterize rifampin-resistant MTB isolates detected by Xpert MTB/RIF. Between April 2016 and February 2018, 2,777 patients were diagnosed with pulmonary TB by Xpert MTB/RIF screening and positive MTB cultures. A total of 74 (2.7%) patients were infected by a drug-resistant (DR-TB) M. tuberculosis strain. Overall HIV prevalence was 14.1%. Patients with HIV infection were at a significantly higher risk for infection with DR-TB strains compared to pan-susceptible strains (28.4% vs. 13.7%, adjusted odds ratio 2.6, 95% confidence interval 1.5-4.4, P = 0.001). Among the detected DR-TB strains, T1 (29.3%), LAM9 (13.3%), and H3 (10.7%) were the most frequent clades. In comparison with previous spoligotypes studies with data collected in 2000-2002 and in 2008-2009 on both sensitive and resistant strains of TB in Haiti, we observed a significant increase in the prevalence of the drug-resistant MTB Spoligo-International-Types (SIT) 137 (X2 clade: 8.1% vs. 0.3% in 2000-02 and 0.9% in 2008-09, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0248707