%0 Journal Article
%T Multidrug-Resistant Tuberculosis in the Democratic Republic of Congo: Analysis of Continuous Surveillance Data from 2007 to 2016
%A Serge Bisuta-Fueza
%A Jean Marie Kayembe-Ntumba
%A Marie-Jose Kabedi-Bajani
%A Pascale Mulomba Sabwe
%A Hippolyte Situakibanza-Nani Tuma
%A Jean-Pierre Simelo
%A Ernest Sumaili-Kiswaya
%A John Ditekemena-Dinanga
%A Patrick Kayembe-Kalambayi
%J Journal of Tuberculosis Research
%P 25-44
%@ 2329-8448
%D 2019
%I Scientific Research Publishing
%R 10.4236/jtr.2019.71004
%X <strong>Background:</strong> For countries with limited resources such as the Democratic Republic of the Congo (DRC), the diagnosis of Multidrug-resistant tuberculosis (MDR-TB) is still insufficient. The MDR-TB identification is done primarily among at-risk groups. The knowledge of the true extent of the MDR-TB remains a major challenge. This study tries to determine the proportion of MDR-TB in each group of presumptive MDR-TB patients and to identify some associated factors. <strong>Methods:</strong> This is an analysis of the DRC surveillance between 2007 and 2016. The proportions were expressed in Percentage. The logistic regression permits to identify the associated factors with the RR-/MDR-TB with adjusted Odds-ratio and 95% CI. Significance defined as p ¡Ü 0.05. <strong>Results:</strong> Overall, 83% (5407/6512) of the MDR-TB presumptive cases had each a TB test. 86.5% (4676/5407) had each a culture and drug sensitive testing (DST) on solid medium, and 24.3% (1312/5407) had performed an Xpert MTB/RIF test. The proportion of those with at least one first-line drug resistance was 59.3% [95% CI 57.2 - 61.4] among which 50.1%, [95% CI 47.9 - 52.3] for the isoniazid, 45.6% [95% CI 43.4 - 47.8] for the rifampicin, 49.9% [95% CI 47.8 - 52.1] for ethambutol and 35.8% [95% CI 33.7 - 37.9] for streptomycin. The confirmation of MDR-TB was 42.8% [95% CI 38.4 - 47.8]. Combining both tests, the proportion of RR-/MDR-TB was 49.6% [95% CI 47.9 - 51.4] for all presumptives. This proportion was 60.0% for failures, 40.7% for relapses and 34.7% for defaulters. Associated factors with the diagnosis of MDR-TB were: aged less than 35 years; prior treatment failure; defaulters; the delay between the collection of sputum and the test completion. <strong>Conclusion:</strong> The proportion of RR-/MDR-TB among the presumptives has been higher than those estimated generally. The National tuberculosis programme (NTP) should improve patient follow-up to reduce TB treatment failures and defaulting. Moreover, while increasing the use of molecular tests, they should reduce sample delivery times when they use culture and DST concomitantly.
%K Multidrug-Resistant Tuberculosis
%K Resistance to Rifampicin
%K Factors Associated
%K DR Congo
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=91483