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Second-line drug resistance among multidrug-resistant tuberculosis patients in Ethiopia : A laboratory-based surveillance

Diriba, Getu ; Alemu, Ayinalem ; Yenew, Bazezew ; Ayano, Betselot Zerihun ; Hailu, Michael ; Buta, Bedo ; Wondimu, Amanuel ; Tefera, Zigba ; Meaza, Abyot and Seid, Getachew , et al. (2025) In Journal of Global Antimicrobial Resistance 42. p.167-174
Abstract

OBJECTIVES: To estimate the proportion of second-line anti-tuberculosis drug resistance among multidrug-resistant tuberculosis (MDR-TB) patients in Ethiopia.

METHODOLOGY: A laboratory-based prospective cross-sectional study was conducted at the National Tuberculosis Reference Laboratory (NTRL), Ethiopia, from February 2022 to July 2024. Phenotypic drug susceptibility testing (pDST) assessed resistance to various second-line anti-tuberculosis drugs. The collected data were entered into Microsoft Excel 2016 and imported into Statistical Package for Social Sciences (SPSS) version 23 for descriptive analysis.

RESULT: Of 468 MDR-TB patients, 262 were new, and 206 were previously treated cases. Pre-extensively drug-resistant... (More)

OBJECTIVES: To estimate the proportion of second-line anti-tuberculosis drug resistance among multidrug-resistant tuberculosis (MDR-TB) patients in Ethiopia.

METHODOLOGY: A laboratory-based prospective cross-sectional study was conducted at the National Tuberculosis Reference Laboratory (NTRL), Ethiopia, from February 2022 to July 2024. Phenotypic drug susceptibility testing (pDST) assessed resistance to various second-line anti-tuberculosis drugs. The collected data were entered into Microsoft Excel 2016 and imported into Statistical Package for Social Sciences (SPSS) version 23 for descriptive analysis.

RESULT: Of 468 MDR-TB patients, 262 were new, and 206 were previously treated cases. Pre-extensively drug-resistant tuberculosis (pre-XDR-TB) was identified in four (1.52%) new cases and seven (3.40%) previously treated cases. Extensively drug-resistant tuberculosis (XDR-TB) was detected in three (1.15%) new cases and two (0.97%) previously treated cases. Overall, 11 (2.35%) cases were classified as pre-XDR-TB, and five (1.07%) as XDR-TB. Combined resistance to fluoroquinolones (FQs) and bedaquiline were detected in four cases (0.85%), comprising three new cases (1.15%) and one previously treated case (0.49%). Resistance to both FQs and linezolid was detected in a single previously treated case (0.49%) and acquired resistance to second-line drugs was identified in four cases.

CONCLUSIONS: Our study showed a prevalence of 2.35% for pre-XDR-TB and 1.07% for XDR-TB among MDR-TB cases, highlighting the importance of continuous surveillance and tailored treatment approaches to control the spread of drug-resistant TB (DR-TB) in Ethiopia. Future studies on MDR-TB surveillance should prioritize the integration of genomic surveillance into routine laboratory-based DR-TB monitoring systems to enhance early detection of resistance patterns, support targeted treatment strategies, and improve overall patient management efforts.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Extensively drug-resistant tuberculosis, Multidrug-resistant tuberculosis, Pre-extensively drug-resistant
in
Journal of Global Antimicrobial Resistance
volume
42
pages
8 pages
publisher
Elsevier
external identifiers
  • pmid:39988072
  • scopus:105000561020
  • pmid:39988072
ISSN
2213-7165
DOI
10.1016/j.jgar.2025.02.014
language
English
LU publication?
no
additional info
Publisher Copyright: © 2025 The Author(s)
id
ee361619-fef2-4f51-a033-8e8d6d368da5
date added to LUP
2025-03-12 13:53:39
date last changed
2025-07-17 14:23:11
@article{ee361619-fef2-4f51-a033-8e8d6d368da5,
  abstract     = {{<p>OBJECTIVES: To estimate the proportion of second-line anti-tuberculosis drug resistance among multidrug-resistant tuberculosis (MDR-TB) patients in Ethiopia.</p><p>METHODOLOGY: A laboratory-based prospective cross-sectional study was conducted at the National Tuberculosis Reference Laboratory (NTRL), Ethiopia, from February 2022 to July 2024. Phenotypic drug susceptibility testing (pDST) assessed resistance to various second-line anti-tuberculosis drugs. The collected data were entered into Microsoft Excel 2016 and imported into Statistical Package for Social Sciences (SPSS) version 23 for descriptive analysis.</p><p>RESULT: Of 468 MDR-TB patients, 262 were new, and 206 were previously treated cases. Pre-extensively drug-resistant tuberculosis (pre-XDR-TB) was identified in four (1.52%) new cases and seven (3.40%) previously treated cases. Extensively drug-resistant tuberculosis (XDR-TB) was detected in three (1.15%) new cases and two (0.97%) previously treated cases. Overall, 11 (2.35%) cases were classified as pre-XDR-TB, and five (1.07%) as XDR-TB. Combined resistance to fluoroquinolones (FQs) and bedaquiline were detected in four cases (0.85%), comprising three new cases (1.15%) and one previously treated case (0.49%). Resistance to both FQs and linezolid was detected in a single previously treated case (0.49%) and acquired resistance to second-line drugs was identified in four cases.</p><p>CONCLUSIONS: Our study showed a prevalence of 2.35% for pre-XDR-TB and 1.07% for XDR-TB among MDR-TB cases, highlighting the importance of continuous surveillance and tailored treatment approaches to control the spread of drug-resistant TB (DR-TB) in Ethiopia. Future studies on MDR-TB surveillance should prioritize the integration of genomic surveillance into routine laboratory-based DR-TB monitoring systems to enhance early detection of resistance patterns, support targeted treatment strategies, and improve overall patient management efforts.</p>}},
  author       = {{Diriba, Getu and Alemu, Ayinalem and Yenew, Bazezew and Ayano, Betselot Zerihun and Hailu, Michael and Buta, Bedo and Wondimu, Amanuel and Tefera, Zigba and Meaza, Abyot and Seid, Getachew and Getahun, Muluwork and Dagne, Biniyam and Mollalign, Hilina and Abebaw, Yeshiwork and Getu, Melak and Tadesse, Mengistu and Belhu, Tegegn and Alemu, Ephrem and Demissie, Minilik and Erresso, Ashenafi and Aga, Getachew and Kumsa, Andargachew and Letta, Taye and Abdella, Saro and Moga, Shewki and Dangisso, Mesay Hailu and Tollera, Getachew and Tadesse, Gemechu}},
  issn         = {{2213-7165}},
  keywords     = {{Extensively drug-resistant tuberculosis; Multidrug-resistant tuberculosis; Pre-extensively drug-resistant}},
  language     = {{eng}},
  pages        = {{167--174}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Global Antimicrobial Resistance}},
  title        = {{Second-line drug resistance among multidrug-resistant tuberculosis patients in Ethiopia : A laboratory-based surveillance}},
  url          = {{http://dx.doi.org/10.1016/j.jgar.2025.02.014}},
  doi          = {{10.1016/j.jgar.2025.02.014}},
  volume       = {{42}},
  year         = {{2025}},
}