An Overview of the Management of Drug-Resistant Tuberculosis in Six French-Speaking African Countries from 2018 to 2022
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Study Site, and Study Population
2.2. Data Collection
2.3. Data Analysis
2.4. Ethics
3. Results
3.1. Screening Strategy
3.1.1. Diagnostic Tests and Indications
3.1.2. Sample Collection and Transport System
3.1.3. Drug-Resistant TB Notification
Number of Confirmed MDR-TB Cases Treated from 2018 to 2022 in the Six Countries
Number of Confirmed XDR-TB Cases Put on Treatment from 2018 to 2022
3.2. Treatment Strategy
3.2.1. Treatment Protocols
3.2.2. Organization of Care
3.2.3. MDR-TB and Extensively DR-TB (XDR-TB) Treatment Results
3.3. Information System
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Country | Available Diagnostic Tests for MDR-TB | |||||
---|---|---|---|---|---|---|
Xpert MTB/RIF | Xpert MTB/RIF ULTRA | Line Probe Assay for First-Line Drugs (FL-LPA) | Line Probe Assay for Second-Line Drugs (SL-LPA) | Loop-Mediated Isothermal Amplification (TB-Lamp) | Culture and Sensitivity Tests | |
Benin | X | X | X | X | X | X |
Burkina Faso | X | X | X | X | X | |
Cameroon | X | X | X | X | X | X |
Niger | X | X | X | X | X | |
Senegal | X | X | X | X | X | |
Togo | X | X | X | X | X |
Country | Year | ||||
---|---|---|---|---|---|
2018 | 2019 | 2020 | 2021 | ||
Benin | Number of GeneXpert | 07 | 29 | 30 | 30 |
Number of microscopy units | 79 | 84 | 89 | 92 | |
Burkina Faso | Number of GeneXpert | 15 | 15 | 18 | 37 |
Number of microscopy units | 111 | 111 | 120 | 128 | |
Cameroon | Number of GeneXpert | 24 | 32 | 33 | 36 |
Number of microscopy units | 255 | 261 | 265 | 306 | |
Niger | Number of GeneXpert | 13 | 21 | 31 | 49 |
Number of microscopy units | 221 | 235 | 238 | 262 | |
Senegal | Number of GeneXpert | 22 | 24 | 48 | 53 |
Number of microscopy units | 132 | 142 | 152 | 153 | |
Togo | Number of GeneXpert | 15 | 15 | 15 | 43 |
Number of microscopy units | 69 | 69 | 82 | 89 | |
All countries | Number of GeneXpert | 96 | 136 | 175 | 248 |
Number of microscopy units | 867 | 902 | 946 | 1030 |
Country | TB MR | 2018 | 2019 | 2020 | 2021 | 2022 | Total |
---|---|---|---|---|---|---|---|
Benin | Number confirmed | 27 | 29 | 31 | 33 | 34 | 154 |
Number treated | 24 | 25 | 24 | 28 | 24 | 125 | |
Proportion treated (%) | 88.9 | 86.2 | 77.4 | 84.8 | 70.6 | 81.2 | |
Burkina Faso | Number confirmed | 101 | 74 | 63 | 82 | 77 | 397 |
Number treated | 88 | 62 | 55 | 75 | 68 | 348 | |
Proportion treated (%) | 87.1 | 83.8 | 87.3 | 91.5 | 88.3 | 87.7 | |
Cameroon | Number confirmed | 176 | 195 | 171 | 138 | 174 | 854 |
Number treated | 151 | 169 | 151 | 108 | 152 | 731 | |
Proportion treated (%) | 85.8 | 86.7 | 88.3 | 78.3 | 87.4 | 85.6 | |
Niger | Number confirmed | 72 | 79 | 79 | 97 | 134 | 461 |
Number treated | 65 | 65 | 69 | 87 | 121 | 407 | |
Proportion treated (%) | 90.3 | 82.3 | 87.3 | 91.7 | 90.3 | 88.4 | |
Senegal | Number confirmed | 99 | 58 | 75 | 79 | 83 | 394 |
Number treated | 86 | 49 | 65 | 69 | 81 | 361 | |
Proportion treated (%) | 86.8 | 84.4 | 86.7 | 87.3 | 97.6 | 91.6 | |
Togo | Number confirmed | 23 | 20 | 16 | 18 | 16 | 93 |
Number treated | 16 | 18 | 12 | 12 | 14 | 72 | |
Proportion treated (%) | 69.6 | 90.0 | 75.0 | 66.7 | 87.5 | 77.4 | |
All countries | Number confirmed | 498 | 455 | 435 | 447 | 518 | 2353 |
Number treated | 430 | 388 | 376 | 379 | 460 | 2033 | |
Proportion treated (%) | 86.3 | 85.3 | 86.4 | 84.8 | 88.8 | 86.4 |
Country | TB MR | 2018 | 2019 | 2020 | 2021 | 2022 |
---|---|---|---|---|---|---|
Benin | Expected number of cases | 90 | 89 | 89 | 88 | 78 |
Number of cases reported | 27 | 29 | 31 | 33 | 34 | |
Gap in percentage (%) | 70 | 67.4 | 65.2 | 62.5 | 56.4 | |
Burkina Faso | Expected number of cases | 210 | 200 | 190 | 190 | 140 |
Number of cases reported | 101 | 74 | 63 | 82 | 77 | |
Gap in percentage (%) | 51.9 | 63.0 | 66.8 | 56.8 | 45.0 | |
Cameroon | Expected number of cases | 920 | 880 | 850 | 810 | 750 |
Number of cases reported | 176 | 195 | 171 | 138 | 174 | |
Gap in percentage (%) | 80.9 | 77.8 | 79.9 | 83.0 | 76.8 | |
Niger | Expected number of cases | 600 | 620 | 630 | 650 | 620 |
Number of cases reported | 72 | 79 | 79 | 97 | 134 | |
Gap in percentage (%) | 88 | 87.3 | 87.5 | 85.1 | 78.4 | |
Senegal | Expected number of cases | 280 | 270 | 270 | 270 | 220 |
Number of cases reported | 99 | 58 | 75 | 79 | 83 | |
Gap in percentage (%) | 64.6 | 78.5 | 72.2 | 70.7 | 62.3 | |
Togo | Expected number of cases | 33 | 32 | 30 | 29 | 22 |
Number of cases reported | 16 | 18 | 12 | 11 | 16 | |
Gap in percentage (%) | 51.5 | 43.7 | 60.0 | 62.1 | 27.3 | |
All countries | Expected number of cases | 2133 | 2091 | 2059 | 2037 | 1830 |
Number of cases reported | 491 | 453 | 431 | 440 | 518 | |
Gap in percentage (%) | 77.0 | 78.3 | 79.1 | 78.4 | 71.7 |
Country | XDR-TB | 2018 | 2019 | 2020 | 2021 | 2022 | Total |
---|---|---|---|---|---|---|---|
Benin | Number confirmed | 0 | 1 | 0 | 0 | 0 | 1 |
Number treated | 0 | 1 | 0 | 0 | 0 | 1 | |
Burkina Faso | Number confirmed | 2 | 4 | 0 | 3 | 2 | 11 |
Number treated | 2 | 4 | 0 | 3 | 2 | 11 | |
Cameroon | Number confirmed | 3 | 5 | 2 | 1 | 1 | 12 |
Number treated | 3 | 5 | 2 | 1 | 1 | 12 | |
Niger | Number confirmed | 3 | 1 | 2 | 11 | 0 | 17 |
Number treated | 3 | 1 | 2 | 11 | 0 | 17 | |
Senegal | Number confirmed | 0 | 3 | 4 | 1 | 2 | 10 |
Number treated | 0 | 3 | 4 | 1 | 2 | 10 | |
Togo | Number confirmed | 1 | 2 | 0 | 0 | 0 | 3 |
Number treated | 1 | 2 | 0 | 0 | 0 | 3 | |
All countries | Number confirmed | 9 | 16 | 6 | 16 | 5 | 52 |
Number treated | 9 | 16 | 6 | 16 | 5 | 52 |
Country | Treatment Protocols |
---|---|
Benin | MDR/RR-TB 2013–2020: 4 KmMfxPtoHCfzEZ/5 MfxCfzEZ From August 2020: 4BdqLfxPtoHCfzEZ/2BdqLfxCfzEZ/3LfxCfzEZ pre-XDR-TB and XDR-TB 6Lzd hH BdqCfzZ/14Lzd (l-M-V) Cfz Z |
Burkina Faso | MDR/RR-TB 2014–2018: 4Km-Mfx-Pto-E-Z-Hhd -Cfz/5 Mfx-E-Z-Cfz 2019: 4Am-Mfx-Pto-E-Z-Hhd -Cfz/5 Mfx-E-Z-Cfz From 2020: 4–6 Bdq[6]-Lfx[Mfx]-Pto-E-Z-Hhd -Cfz/5 Lfx[Mfx]-E-Z-Cfz pre-XDR-TB and XDR-TB 2018–August 2021: 6 Am-Bdq-Lfx-Lzd-Cfz-Z-Eto-PAS/14 Lfx-Cfz-Z-Eto-PAS Since August 2021: 6BPaL |
Cameroon | MDR/RR-TB 2013–2018: 4–6 Km Hh Pto Mfx Cfz E Z/5 Mfx Cfz E Z 2018–2020: 4–6 Am Hh Pto Mfx Cfz E Z/5 Mfx Cfz E Z Since 01 June 2021: 4–6 Bdq (6) Hh Pto Mfx Cfz E Z/5 Mfx Cfz E Z pre-XDR-TB and XDR-TB 2013–2022: 4–6 Lzd-Hh-Bdq-Dlm-Cfz-Z/8 Bdq-Dlm-Cfz-Z |
Niger | MDR/RR-TB 10/2015 to present: Lzd has replaced ISL for hearing loss (oral) From 2021: fully oral regimes in operational research conditions - TB-RR/FQ-S: 4–6 Lzd-Hh-Pto-Lfxh-Bdq-Cfz-Z/5 Lfxh-Bdq-Cfz-Z - TB-RR/FQ-R: 4–6 Lzd-Hh-Bdq-Dlm-Cfz-Z/5 Bdq-Dlm-Cfz-Z pre-XDR-TB and XDR-TB Individual plan |
Senegal | MDR/RR-TB 2015 (Q3)–2019: 4–6 Km-Mfx-Pto-Cfz-HFD-E-Z/5 Mfx-E-Cfz-Z 6–8 Am-Lfx-Eto-PAS- Cs-Z/12–14 Z-Lfx-Eto- PAS (RR/MR TB cases not eligible for short regimen: pregnant women, extrapulmonary) 2020–2021: 4 (Am-Mfx-Pto-Cfz--E-Z)/5 (Mfx-E-Cfz-Z) Since 2021 Adults and children aged 6 and over:
|
Togo | MDR/RR-TB
|
Country | Organisation of Care |
---|---|
Benin |
|
Burkina Faso |
|
Cameroon |
|
Niger |
|
Senegal |
|
Togo |
|
Country | Treatment Results | Year | |||
---|---|---|---|---|---|
2018 | 2019 | 2020 | 2021 | ||
Benin | Number of patients (N) | 27 | 29 | 31 | 33 |
Therapeutic success n (%) | 19 (70.4) | 25 (86.2) | 26 (83.9) | 27 (81.8) | |
Failure n (%) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Loss to follow-up n (%) | 3 (11.1) | 0 (0.0) | 1 (3.2) | 2 (6.1) | |
Deceased n (%) | 5 (18.5) | 4 (13.8) | 3 (9.7) | 4 (12.1) | |
Not assessed n (%) | 0 (0.0) | 0 (0.0) | 1 (3.2) | 0 (0.0) | |
Burkina Faso | Number of patients (N) | 101 | 74 | 63 | 82 |
Therapeutic success n (%) | 63 (62.4) | 43 (58.1) | 41 (65.1) | 44 (53.7) | |
Failure n (%) | 3 (3.0) | 3 (4.1) | 1 (1.6) | 5 (6.1) | |
Loss to follow-up n (%) | 5 (5.0) | 14 (18.9) | 4 (6.3) | 8 (9.8) | |
Deceased n (%) | 30 (29.7) | 14 (18.9) | 17 (27.0) | 25 (30.5) | |
Not assessed n (%) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Cameroon | Number of patients (N) | 176 | 195 | 171 | 138 |
Therapeutic success n (%) | 117 (66.5) | 146 (74.9) | 76 (44.4) | NAv * | |
Failure n (%) | 3 (1.7) | 3 (1.5) | 5 (2.9) | NAv | |
Loss to follow-up n (%) | 8 (4.5) | 6 (3.1) | 4 (2.3) | NAv | |
Deceased n (%) | 16 (9.1) | 15 (7.7) | 16 (9.4) | NAv | |
Not assessed n (%) | 32 (18.2) | 25 (12.8) | 70 (40.9) | NAv | |
Niger | Number of patients (N) | 72 | 79 | 79 | 87 |
Therapeutic success n (%) | 55 (76.4) | 68 (86.1) | 59 (74.7) | 67 (76.7) | |
Failure n (%) | 4 (5.5) | 1 (1.2) | 3 (3.8) | 1 (1.7) | |
Loss to follow-up n (%) | 1 (1.4) | 4 (5.1) | 3 (3.8) | 7 (8.3) | |
Deceased n (%) | 12 (16.7) | 6 (7.6) | 14 (17.7) | 12 (13.3) | |
Not assessed n (%) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Senegal | Number of patients (N) | 86 | 49 | 65 | 69 |
Therapeutic success n (%) | 75 (87.2) | 40 (81.6) | 54 (83.0) | NAv | |
Failure n (%) | 3 (3.4) | 3 (6.1) | 2 (3.0) | NAv | |
Loss to follow-up n (%) | 2 (0.33) | 1 (2) | 1 (1.5) | NAv | |
Deceased n (%) | 6 (6.9) | 5 (10.2) | 8 (12.3) | NAv | |
Not assessed n (%) | 0 | 0 | 0 | NAv | |
Togo | Number of patients (N) | 16 | 18 | 12 | 11 |
Therapeutic success n (%) | 13 (81.3) | 14 (77.8) | 8 (66.7) | 10 (90.9) | |
Failure n (%) | 1 (6.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Loss to follow-up n (%) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Deceased n (%) | 2 (12.5) | 4 (22.2) | 4 (33.3) | 1 (9.1) | |
Not assessed n (%) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
All countries | Number of patients (N) | 478 | 444 | 421 | 420 |
Therapeutic success n (%) | 342 (71.5) | 336 (75.7) | 264 (62.7) | NAp ** | |
Failure n (%) | 14 (2.9) | 10 (2.3) | 11 (2.6) | NAp | |
Loss to follow-up n (%) | 19 (4.0) | 25 (5.6) | 13 (3.1) | NAp | |
Deceased n (%) | 71 (14.9) | 48 (10.8) | 62 (14.7) | NAp | |
Not assessed n (%) | 32 (6.7) | 25 (5.6) | 71 (16.9) | NA |
Country | Treatment Results | Year | |||
---|---|---|---|---|---|
2018 | 2019 | 2020 | 2021 | ||
Benin | Number of patients (N) | 0 | 1 | 0 | 0 |
Therapeutic success n (%) | 0 | 1 | 0 | 0 | |
Failure n (%) | 0 | 0 | 0 | 0 | |
Loss to follow-up n (%) | 0 | 0 | 0 | 0 | |
Deceased n (%) | 0 | 0 | 0 | 0 | |
Not assessed n (%) | 0 | 0 | 0 | 0 | |
Burkina Faso | Number of patients (N) | 2 | 4 | 0 | 3 |
Therapeutic success n (%) | 1 | 1 | 0 | 1 | |
Failure n (%) | 0 | 0 | 0 | 0 | |
Loss to follow-up n (%) | 0 | 0 | 0 | 0 | |
Deceased n (%) | 1 | 2 | 0 | 2 | |
Not assessed n (%) | 0 | 1 | 0 | 0 | |
Cameroon | Number of patients (N) | 3 | 5 | 2 | 1 |
Therapeutic success n (%) | 1 | 2 | 1 | 1 | |
Failure n (%) | 2 | 0 | 0 | 0 | |
Loss to follow-up n (%) | 0 | 0 | 1 | 0 | |
Deceased n (%) | 0 | 3 | 0 | 0 | |
Not assessed n (%) | 0 | 0 | 0 | 0 | |
Niger | Number of patients (N) | 6 | 4 | 4 | 11 |
Therapeutic success n (%) | 4 | 4 | 4 | 9 | |
Failure n (%) | 0 | 0 | 0 | 0 | |
Loss to follow-up n (%) | 0 | 0 | 0 | 0 | |
Deceased n (%) | 2 | 0 | 0 | 2 | |
Not assessed n (%) | 0 | 0 | 0 | 0 | |
Senegal | Number of patients (N) | 0 | 3 | 4 | 1 |
Therapeutic success n (%) | 0 | 1 | 2 | 0 | |
Failure n (%) | 0 | 1 | 0 | 0 | |
Loss to follow-up n (%) | 0 | 0 | 0 | 0 | |
Deceased n (%) | 0 | 1 | 2 | 1 | |
Not assessed n (%) | 0 | 0 | 0 | 0 | |
Togo | Number of patients (N) | 1 | 2 | 0 | 0 |
Therapeutic success n (%) | 0 | 2 | 0 | 0 | |
Failure n (%) | 0 | 0 | 0 | 0 | |
Loss to follow-up n (%) | 0 | 0 | 0 | 0 | |
Deceased n (%) | 1 | 0 | 0 | 0 | |
Not assessed n (%) | 0 | 0 | 0 | 0 | |
All countries | Number of patients (N) | 12 | 19 | 10 | 16 |
Therapeutic success n (%) | 6 | 11 | 7 | 11 | |
Failure n (%) | 2 | 1 | 0 | 0 | |
Loss to follow-up n (%) | 0 | 0 | 1 | 0 | |
Deceased n (%) | 4 | 6 | 2 | 5 | |
Not assessed n (%) | 0 | 1 | 0 | 0 |
Country | Tools |
---|---|
Benin |
|
Burkina Faso |
|
Cameroon |
|
Niger |
|
Senegal |
|
Togo |
|
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Share and Cite
Badoum, G.; Ouédraogo, A.R.; Fiogbé, A.A.; Kuate Kuate, A.; Soumana, A.; Diop, Y.M.; Dogo, M.F.; Mbitikon, O.B.; Combary, A.; Agodokpessi, G.; et al. An Overview of the Management of Drug-Resistant Tuberculosis in Six French-Speaking African Countries from 2018 to 2022. Trop. Med. Infect. Dis. 2024, 9, 176. https://doi.org/10.3390/tropicalmed9080176
Badoum G, Ouédraogo AR, Fiogbé AA, Kuate Kuate A, Soumana A, Diop YM, Dogo MF, Mbitikon OB, Combary A, Agodokpessi G, et al. An Overview of the Management of Drug-Resistant Tuberculosis in Six French-Speaking African Countries from 2018 to 2022. Tropical Medicine and Infectious Disease. 2024; 9(8):176. https://doi.org/10.3390/tropicalmed9080176
Chicago/Turabian StyleBadoum, Gisèle, Abdoul R. Ouédraogo, Attannon A. Fiogbé, Albert Kuate Kuate, Alphazazi Soumana, Yacine Mar Diop, Mohammed F. Dogo, Olivia B. Mbitikon, Adjima Combary, Gildas Agodokpessi, and et al. 2024. "An Overview of the Management of Drug-Resistant Tuberculosis in Six French-Speaking African Countries from 2018 to 2022" Tropical Medicine and Infectious Disease 9, no. 8: 176. https://doi.org/10.3390/tropicalmed9080176