TY - JOUR
T1 - Survey of tuberculosis drug resistance among Tibetan refugees in India
AU - Salvo, F.
AU - Dorjee, K.
AU - Dierberg, K.
AU - Cronin, W.
AU - Sadutshang, T. D.
AU - Migliori, G. B.
AU - Rodrigues, C.
AU - Trentini, F.
AU - Di Serio, C.
AU - Chaisson, R.
AU - Cirillo, D. M.
PY - 2014/6/1
Y1 - 2014/6/1
N2 - SETTING: Tuberculosis (TB) is a major health problem among Tibetans living in exile in India. Although drug-resistant TB is considered common in clinical practice, precise data are lacking. OBJECTIVE: To determine the proportion of drug-resistant cases among new and previously treated Tibetan TB patients. DESIGN: In a drug resistance survey in five Tibetan settlements in India, culture and drug susceptibility testing (DST) for first-line drugs were performed among all consecutive new and previously treated TB cases from April 2010 to September 2011. DST against kanamycin (KM), ethionamide, para-aminosalicylic acid and ofloxacin (OFX) was performed on multidrug-resistant TB (MDR-TB) isolates. RESULTS: Of 307 patients enrolled in the study, 264 (193 new and 71 previously treated) were culture-positive and had DST available. All patients tested for the human immunodeficiency virus (n = 250) were negative. Among new TB cases, 14.5% had MDR-TB and 5.7% were isoniazid (INH) monoresistant. Among previously treated cases, 31.4% had MDR-TB and 12.7% were INH-monoresistant. Of the MDR-TB isolates, 28.6% of new and 26.1% of previously treated cases were OFX-resistant, while 7.1% of new cases and 8.7% of previously treated cases were KM-resistant. Three patients had extensively drug-resistant TB. CONCLUSIONS: MDR-TB is common in new and previously treated Tibetans in India, who also show additional complex resistance patterns. Of particular concern is the high percentage of MDR-TB strains resistant to OFX, KM or both.
AB - SETTING: Tuberculosis (TB) is a major health problem among Tibetans living in exile in India. Although drug-resistant TB is considered common in clinical practice, precise data are lacking. OBJECTIVE: To determine the proportion of drug-resistant cases among new and previously treated Tibetan TB patients. DESIGN: In a drug resistance survey in five Tibetan settlements in India, culture and drug susceptibility testing (DST) for first-line drugs were performed among all consecutive new and previously treated TB cases from April 2010 to September 2011. DST against kanamycin (KM), ethionamide, para-aminosalicylic acid and ofloxacin (OFX) was performed on multidrug-resistant TB (MDR-TB) isolates. RESULTS: Of 307 patients enrolled in the study, 264 (193 new and 71 previously treated) were culture-positive and had DST available. All patients tested for the human immunodeficiency virus (n = 250) were negative. Among new TB cases, 14.5% had MDR-TB and 5.7% were isoniazid (INH) monoresistant. Among previously treated cases, 31.4% had MDR-TB and 12.7% were INH-monoresistant. Of the MDR-TB isolates, 28.6% of new and 26.1% of previously treated cases were OFX-resistant, while 7.1% of new cases and 8.7% of previously treated cases were KM-resistant. Three patients had extensively drug-resistant TB. CONCLUSIONS: MDR-TB is common in new and previously treated Tibetans in India, who also show additional complex resistance patterns. Of particular concern is the high percentage of MDR-TB strains resistant to OFX, KM or both.
KW - Drug resistance survey
KW - MDR-TB
KW - Tibetan refugees
KW - Tuberculosis in refugees
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U2 - 10.5588/ijtld.13.0516
DO - 10.5588/ijtld.13.0516
M3 - Article
AN - SCOPUS:84901269030
VL - 18
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
SN - 1027-3719
IS - 6
ER -