title: MDR-TB treatment needs in patients previously treated for TB in Cotonou, Benin.
abstract: METHODS
  Centre National Hospitalier de Pneumo-Phtisi-ologie, Cotonou, Benin.
  
  
  OBJECTIVE
  To determine the proportion of individuals needing treatment for multidrug-resistant tuberculosis (MDR-TB) among patients previously treated for TB.
  
  
  METHODS
  A retrospective cross-sectional study of all patients previously treated for TB in Cotonou from 2003 to 2011.
  
  
  RESULTS
  Of 956 patients on retreatment, 897 (94%) underwent culture and/or a line-probe assay. For different reasons, 594 (66%) underwent drug susceptibility testing for rifampicin (RMP), of whom 95 (16%) had RMP resistance (68 multidrug-resistance [MDR] and 27 other RMP resistance) and therefore needed treatment for MDR-TB. These represent 39% of patients who failed/relapsed after standardised retreatment, and 20% of those who failed, 19% of defaulters and 11% of relapses after first-line treatment. Residence outside of Benin was associated with a higher risk of RMP resistance (RR 3.13, 95%CI 2.19-4.48, P < 0.01). From 2003 to 2011, the prevalence of RMP resistance decreased from 25% to 5% among patients living in Benin. Human immunodeficiency virus (HIV) prevalence was 25%; no association was found between HIV and RMP resistance. Of patients failing treatment, 48% were fully susceptible, 22% were monoresistant and 8% polyresistant.
  
  
  CONCLUSIONS
  The majority of patients who fail retreatment or first-line treatment in Cotonou do not require empirical treatment for MDR-TB.
authors.affiliation: National Tuberculosis Programme, Cotonou, Benin ; International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Ade
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Trébucq
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: National Tuberculosis Programme, Cotonou, Benin.
authors.forename: D
authors.initials: D
authors.lastname: Affolabi
authors.affiliation: National Tuberculosis Programme, Cotonou, Benin.
authors.forename: G
authors.initials: G
authors.lastname: Ade
authors.affiliation: National Tuberculosis Programme, Cotonou, Benin.
authors.forename: G
authors.initials: G
authors.lastname: Agodokpessi
authors.affiliation: National Tuberculosis Programme, Cotonou, Benin.
authors.forename: P
authors.initials: P
authors.lastname: Wachinou
authors.affiliation: National Tuberculosis Programme, Cotonou, Benin.
authors.forename: S
authors.initials: S
authors.lastname: Anagonou
authors.affiliation: National Tuberculosis Programme, Cotonou, Benin.
authors.forename: M
authors.initials: M
authors.lastname: Gninafon
keywords: group; multidrug resistance; retreatment; rifampicin