Epidemiology and outcomes of multidrug-resistant tuberculosis in Rwanda

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Multidrug-resistant tuberculosis (MDR-TB) presents a major public health concern in Rwanda.
• Understanding the characteristics and outcomes of MDR-TB is crucial for effective control.

Purpose of the Study:

• To describe the epidemiological profile of MDR-TB cases in Rwanda.
• To evaluate diagnostic methods and treatment success rates for MDR-TB.
• To identify risk factors associated with MDR-TB mortality.

Main Methods:

• Retrospective analysis of MDR-TB cases diagnosed between July 1, 2019, and June 30, 2023.
• Inclusion of epidemiological data, diagnostic test results (GeneXpert), and treatment outcomes.
• Statistical analysis to determine prevalence, success rates, and mortality risk factors.

Main Results:

• MDR-TB accounted for 0.96% of all tuberculosis cases (227/23,476).
• The study observed male predominance (80.6%) with a mean age of 39.6 years; 96.9% had pulmonary TB, and 20.3% were HIV co-infected.
• GeneXpert showed 92.9% sensitivity for rifampicin/isoniazid resistance. Overall treatment success was 93.5%, with a 5.3% mortality rate. HIV co-infection and malnutrition were mortality risk factors.

Conclusions:

• Effective MDR-TB control in Rwanda requires robust diagnostic and treatment strategies.
• High treatment success rates indicate the potential for effective management.
• Addressing risk factors like HIV co-infection and malnutrition is vital for reducing MDR-TB mortality.