Rates of anti-tuberculosis drug resistance in Kampala-Uganda are low and not associated with HIV infection

• Published in: PloS one Vol. 6; no. 1; p. e16130
• Main Authors: Lukoye, Deus, Cobelens, Frank G J, Ezati, Nicholas, Kirimunda, Samuel, Adatu, Francis E, Lule, Joseph K, Nuwaha, Fred, Joloba, Moses L
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 10-01-2011; Public Library of Science (PLoS)
• Subjects: Antitubercular agents; Antitubercular Agents - pharmacology; Development and progression; Diagnosis; Drug resistance; Drug therapy; Enrollments; Epidemics; Health aspects; Health care; Health Personnel; Health sciences; Health surveillance; HIV; HIV infections; HIV Infections - complications; HIV Infections - epidemiology; Hospitals; Human immunodeficiency virus; Humans; Incidence; Infections; Interviews; Leprosy; Medical research; Medical tests; Medicine; Microbial drug resistance; Mortality; Multidrug resistance; Multidrug resistant organisms; Mycobacterium; Patient compliance; Patients; Public health; Risk factors; Smear; Studies; Substance abuse treatment; Tuberculosis; Tuberculosis, Multidrug-Resistant - complications; Tuberculosis, Multidrug-Resistant - epidemiology; Tuberculosis, Multidrug-Resistant - transmission; Uganda - epidemiology; Uganda; Kampala Uganda
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0016130

Drug resistance among tuberculosis patients in sub-Saharan Africa is increasing, possibly due to association with HIV infection. We studied drug resistance and HIV infection in a representative sample of 533 smear-positive tuberculosis patients diagnosed in Kampala, Uganda.
Among 473 new patients, multidrug resistance was found in 5 (1.1%, 95% CI 0.3-2.5) and resistance to any drug in 57 (12.1%, 9.3-15.3). Among 60 previously treated patients this was 7 (11.7%, 4.8-22.6) and 17 (28.3%; 17.5-41.4), respectively. Of 517 patients with HIV results, 165 (31.9%, 27.9-36.1) tested positive. Neither multidrug (adjusted odds ratio (OR(adj)) 0.7; 95% CI 0.19-2.6) nor any resistance (OR(adj) 0.7; 0.43-1.3) was associated with HIV status. Primary resistance to any drug was more common among patients who had worked in health care (OR(adj) 3.5; 1.0-12.0).
Anti-tuberculosis drug resistance rates in Kampala are low and not associated with HIV infection, but may be associated with exposure during health care.