title: Low Occurrence of Tuberculosis Drug Resistance among Pulmonary Tuberculosis Patients from an Urban Setting, with a Long-Running DOTS Program in Zambia.
abstract: We set out to determine the levels of Mycobacterium tuberculosis resistance to first- and second-line TB drugs in an urban population in Zambia. Sputum samples were collected consecutively from all smear-positive, new and previously treated patients, from four diagnostic centres in Ndola between January and July 2006. Drug susceptibility testing was performed using the proportion method against four first- and two second-line TB drugs. Results. Among 156 new cases, any resistance was observed to be 7.7%, monoresistance to isoniazid and rifampicin was 4.5% and 1.3%, respectively. Of 31 retreatment cases, any resistance was observed to be 16.1%, monoresistance to isoniazid and rifampicin was 3.3% for each drug, and one case of resistance to both isoniazid and rifampicin (multidrug resistance) was detected. No resistance to kanamycin or ofloxacin was detected. Conclusion. Although not representative of the country, these results show low levels of drug resistance in a community with a long-standing DOTS experience. Resource constrained countries may reduce TB drug resistance by implementing community-based strategies that enhance treatment completion.
authors.affiliation: Biomedical Sciences Department, Tropical Diseases Research Centre, P.O. Box 71769, Ndola, Zambia.
authors.forename: Chanda
authors.initials: C
authors.lastname: Mulenga
authors.forename: Allan
authors.initials: A
authors.lastname: Chonde
authors.forename: Innocent C
authors.initials: IC
authors.lastname: Bwalya
authors.forename: Nathan
authors.initials: N
authors.lastname: Kapata
authors.forename: Mathilda
authors.initials: M
authors.lastname: Kakungu-Simpungwe
authors.forename: Sven
authors.initials: S
authors.lastname: Docx
authors.forename: Krista
authors.initials: K
authors.lastname: Fissette
authors.forename: Isdore Chola
authors.initials: IC
authors.lastname: Shamputa
authors.forename: Françoise
authors.initials: F
authors.lastname: Portaels
authors.forename: Leen
authors.initials: L
authors.lastname: Rigouts