[Pre-extensively and extensively drug-resistant tuberculosis, in Libreville, Gabon]

Very few studies have been devoted to extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis (TB) in Gabon.

The aim of the present study is to present the epidemiology of pre-XDR and XDR TB and the evolution over time of patients with multidrug-resistant TB.

This retrospective study covered the activities from 2019 to 2022 of the Nkembo anti-tuberculosis center.

Fifteen patients were eligible, including 11 (73.3%) pre-XDR patients and 4 (26.7%) XDR-TB patients. Three (20.0%) patients had HIV/TB co-infection. The sample consisted of 7 men (46.7%) and 8 women (53.3%), a sex ratio (M/F) of 0.87. The average age was 35.6 years, and the median 34 years, with extremes of 23 and 60 years. Eight patients (53.3%) represented new cases of pre-XDR or XDR-TB tuberculosis. The majority (60%; n=9) came from deprived neighborhoods with widespread promiscuity. The therapeutic success rate among pre-XDR patients was 4 (36.4%) versus 2 (50.0%) among XDR-TB patients. Reported mortality occurred 5 (33.3%) patients during treatment, including 3 pre-XDR and 2 XDR-TB patients. In all cases, they died before the end of the first trimester of follow-up.

The high frequency of primary pre-extensively drug-resistant tuberculosis underscores the pervasiveness of resistance to anti-tuberculosis drugs and underlines a pressing need for detection of contact cases and early treatment.