title: Multi drug resistant tuberculosis in Mosango, a rural area in the Democratic Republic of Congo.
abstract: Multidrug Resistant Tuberculosis (MDR-TB) is a serious threat which jeopardizes the worldwide efforts to control TB. The Democratic Republic of Congo (DRC) is one of 27 countries with a high burden of MDR-TB. Data on the magnitude, trends, and the distribution of MDR-TB in DRC are scanty. Kinshasa, the capital city of DRC which accounts for 20% of all TB cases nationwide, is notifying more than 80% of all MDR suspects. We report here a cluster of MDR-TB cases that was investigated in the Mosango health district, in the Bandundu south Province, DRC in 2008. Phenotypic Drug Sensitivity Testing and DNA sequencing were performed on 18 sputum specimens collected from 4 MDR-TB suspects and 5 household contacts. Sequencing data confirmed that the 4 suspects were indeed Rifampicin resistant cases. Sequencing of the rpoB gene showed that 3 cases (patients A, B and D) had a single mutation encoding a substitution to 526Tyr, 531Trp and 526Leu respectively. Patient C had a double mutation encoding a change to 531Leu and 633Leu. Two of the investigated cases died within 4 months of a second-line treatment course. Results highlight the need to enhance adequate laboratory services within the country for both clinical as well as surveillance purposes.
authors.affiliation: National Tuberculosis Program, Kinshasa, Democratic Republic of Congo; Institut National de Recherche Bio-Médicale, Kinshasa, Democratic Republic of Congo; Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Michel Kayomo
authors.initials: MK
authors.lastname: Kaswa
authors.affiliation: National Tuberculosis Program, Kinshasa, Democratic Republic of Congo.
authors.forename: Serge
authors.initials: S
authors.lastname: Bisuta
authors.affiliation: National Tuberculosis Program, Kinshasa, Democratic Republic of Congo.
authors.forename: Georges
authors.initials: G
authors.lastname: Kabuya
authors.affiliation: Institut National de Recherche Bio-Médicale, Kinshasa, Democratic Republic of Congo.
authors.forename: Octavie
authors.initials: O
authors.lastname: Lunguya
authors.affiliation: National Tuberculosis Program, Kinshasa, Democratic Republic of Congo.
authors.forename: André
authors.initials: A
authors.lastname: Ndongosieme
authors.affiliation: Institut National de Recherche Bio-Médicale, Kinshasa, Democratic Republic of Congo.
authors.forename: Jean Jacques
authors.initials: JJ
authors.lastname: Muyembe
authors.affiliation: Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Armand
authors.initials: A
authors.lastname: Van Deun
authors.affiliation: Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Marleen
authors.initials: M
authors.lastname: Boelaert
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D016000:Cluster Analysis; D012321:DNA-Directed RNA Polymerases; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010641:Phenotype; D012293:Rifampin / Q000627:therapeutic use; D012424:Rural Population; D017422:Sequence Analysis, DNA; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D001426:Bacterial Proteins; C505805:rpoB protein, Mycobacterium tuberculosis; D012321:DNA-Directed RNA Polymerases; D012293:Rifampin
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