title: Primary drug resistance to anti-tuberculosis drugs in major towns of Amhara region, Ethiopia.
abstract: Drug resistance is a major obstacle to effective TB control program performance. In this study, we assessed the prevalence of primary drug resistance in Mycobacterium tuberculosis (Mtb) isolates in Amhara Region, Ethiopia. A total of 112 Mtb isolates from cases with newly diagnosed pulmonary TB were subjected to drug susceptibility testing (DST) in a cross-sectional study. Isolates were tested for sensitivity to isoniazid, rifampicin, ethambutol, and streptomycin using the MGIT 960 protocol. A total of 93 Mtb isolates yielded valid DST results and 28 (30.1%) were resistant to one or more of first line anti-TB drugs. One isolate (1.0%) was multi-drug resistant (MDR), five (5.4%) were classified as poly-resistant and 22 showed single drug resistance to either streptomycin (n = 19) or isoniazid (n = 3). Isolates from HIV-positive patients were more likely to be resistant to at least one of the four anti-TB drugs compared with HIV-negative individuals (odds ratio 2.76, 95% confidence interval 1.06-7.22; p = 0.03). The study showed a high prevalence of primary drug resistance. Even though the prevalence of MDR was low, conditions that can contribute to the development of MDR are increasing. Therefore, regular monitoring of drug resistance and enhanced implementation of TB/HIV collaborative activities in the study region are imperative.
authors.affiliation: Norwegian Institute of Public Health, Nydalen, Oslo, Norway. yimsolo@yahoo.com
authors.forename: Solomon Abebe
authors.initials: SA
authors.lastname: Yimer
authors.forename: Mulualem
authors.initials: M
authors.lastname: Agonafir
authors.forename: Yohannes
authors.initials: Y
authors.lastname: Derese
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Sani
authors.forename: Gunnar A
authors.initials: GA
authors.lastname: Bjune
authors.forename: Carol
authors.initials: C
authors.lastname: Holm-Hansen
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D015995:Prevalence; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents