First national survey of Mycobacterium tuberculosis drug resistance, Madagascar, 2005-2006.

H. Ramarokoto (1) , O. Ratsirahonana (2) , J. L. Soares (3) , J. Ravaosolo (2) , P. Ravololonandriana (3) , A. Rakotoarisaonina (2) , G. Ranjalahy (2) , S. Ranaivohajaina (2) , M. Mosa (4) , R. Robinson (4) , M. Ratsitorahina (3) , V. Rasolofo (3) , B. Rarivoson (2)

1 CNRM - Centre National de Référence des Mycobactéries
2 PNLT - Programme National de Lutte contre la Tuberculose
3 Institut Pasteur de Madagascar
4 Department of Emergency and Disease Control

SETTING: A national survey of Mycobacterium tuberculosis resistance was conducted for the first time in Madagascar between October 2005 and July 2007. OBJECTIVE: To determine resistance rates among new and previously treated cases of pulmonary tuberculosis. METHODS: In a cluster sampling representative of the general population of the country, 1275 smear-positive tuberculosis patients recruited at 34 sites, 926 new patients and 87 previously treated patients underwent drug susceptibility testing against rifampicin (RMP), isoniazid (INH), streptomycin and ethambutol on Löwenstein-Jensen medium using the indirect proportion method. RESULTS: Resistance among new cases was 6.5% (95%CI 4.9-8) and among previously treated cases it was 11.5% (95%CI 4.8-18.2). Monoresistance among new cases was 5.8% (95%CI 4.2-7.3), mainly to INH (3.7%). Multiresistance to INH and RMP was 0.2% (95%CI 0-0.5) among new cases and 3.4% (95%CI 0-7.2) among previously treated cases. No significant difference was noted with regard to sex or age. CONCLUSION: The rates of resistance among new and previously treated cases remain relatively low in Madagascar.

Mots clés: tuberculose; Madagascar; résistance; enquête nationale

Domaines: Santé publique et épidémiologie

H. Ramarokoto, O. Ratsirahonana, J. L. Soares, J. Ravaosolo, P. Ravololonandriana, et al.. First national survey of Mycobacterium tuberculosis drug resistance, Madagascar, 2005-2006.. International Journal of Tuberculosis and Lung Disease, 2010, 14 (6), pp.745-50. ⟨pasteur-00614782⟩