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


CONCLUSIONS
The rates of resistance among new and previously treated cases remain relatively low in Madagascar.
Ramarokoto
H
H
National Tuberculosis Programme Madagascar, Department of Tuberculosis and Leprosy Control, Ministry of Health and Family Planning, Antananarivo, Madagascar. herimana@pasteur.mg
Ratsirahonana
O
O
Soares
J L
JL
Ravaosolo
J
J
Ravololonandriana
P
P
Rakotoarisaonina
A
A
Ranjalahy
G
G
Ranaivohajaina
S
S
Mosa
M
M
Robinson
R
R
Ratsitorahina
M
M
Rasolofo
V
V
Rarivoson
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008270:Madagascar / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
D000995:Antitubercular Agents