Drug-resistant tuberculosis in Sierra Leone

Area of Science:

• Microbiology
• Infectious Diseases
• Public Health

Background:

• Tuberculosis (TB) remains a global health challenge, with drug resistance complicating treatment outcomes.
• Drug resistance in Mycobacterium tuberculosis is influenced by various factors, including treatment adherence and drug availability.
• Sierra Leone faces challenges in managing infectious diseases due to resource limitations.

Purpose of the Study:

• To determine the incidence of drug resistance in tubercle bacilli from patients in Sierra Leone.
• To identify patterns of drug resistance, including single and multiple drug resistance.
• To investigate the potential causes of observed drug resistance patterns.

Main Methods:

• Culture and sensitivity testing of Mycobacterium tuberculosis isolates.
• Analysis of clinical data from patients with suspected drug-resistant tuberculosis.
• Retrospective review of drug resistance patterns over a six-year period (1978-1984).

Main Results:

• An overall incidence of 10.5% isoniazid resistance was observed.
• 7.7% of isolates showed resistance to both isoniazid and streptomycin.
• Incidence of resistance to rifampicin (1.3%) and ethambutol (0.8%) was lower, with multiple drug resistance being more common than single drug resistance.

Conclusions:

• High rates of drug resistance, particularly to first-line drugs like isoniazid and streptomycin, are prevalent in Sierra Leone.
• Inadequate and irregular supplies of anti-tuberculosis drugs are a major contributing factor to the observed resistance.
• Urgent interventions are needed to ensure consistent drug availability and combat the rise of drug-resistant tuberculosis.