title: Antituberculous drug resistance in central Haiti.
abstract: To determine the prevalence of antituberculous drug resistance in Haiti, we conducted a 1-yr survey in a central district. From a bacillary positive (smear and/or culture positive) case rate of 80/100,000, there were 282 patients from whom Mycobacterium tuberculosis was cultured. Each isolate was packaged and delivered to Canada where speciation and drug susceptibility testing were performed. Reported resistances are those using the proportions method (Laboratory Center for Disease Control, Ottawa, Canada). Resistance to one or more drugs was found in 22% of isolates. Age was the most important predictor of resistance in Haiti; resistance rates for age groups less than 14, 14 to 29, 30 to 44, greater than or equal to 45 were 8, 19, 22, and 31%, respectively. In patients not known to have received antituberculous drugs in the past, resistances were isoniazid (19%), streptomycin (5%), ethambutol (2%), ethionamide (2%), rifampin (1%). We conclude that antituberculous drug resistance is prevalent in Haiti, especially in older age groups, and that in persons with no known antituberculous drug use in the past, resistance to isoniazid is significant.
authors.affiliation: Department of Medicine, Hôpital Albert Schweitzer, Deschapelles, Haiti.
authors.forename: M
authors.initials: M
authors.lastname: Scalcini
authors.forename: G
authors.initials: G
authors.lastname: Carré
authors.forename: M
authors.initials: M
authors.lastname: Jean-Baptiste
authors.forename: E
authors.initials: E
authors.lastname: Hershfield
authors.forename: S
authors.initials: S
authors.lastname: Parker
authors.forename: J
authors.initials: J
authors.lastname: Wolfe
authors.forename: K
authors.initials: K
authors.lastname: Nelz
authors.forename: R
authors.initials: R
authors.lastname: Long
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D004977:Ethambutol / Q000494:pharmacology / Q000627:therapeutic use; D005000:Ethionamide / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006205:Haiti; D006801:Humans; D007223:Infant; D007538:Isoniazid / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D012293:Rifampin / Q000494:pharmacology / Q000627:therapeutic use; D013307:Streptomycin / Q000494:pharmacology / Q000627:therapeutic use; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D004977:Ethambutol; D005000:Ethionamide; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin