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

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), Ethi...

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Main Authors: Getu Diriba, Ayinalem Alemu, Bazezew Yenew, Betselot Zerihun Ayano, Michael Hailu, Bedo Buta, Amanuel Wondimu, Zigba Tefera, Abyot Meaza, Getachew Seid, Muluwork Getahun, Biniyam Dagne, Hilina Mollalign, Yeshiwork Abebaw, Melak Getu, Mengistu Tadesse, Tegegn Belhu, Ephrem Alemu, Minilik Demissie, Ashenafi Erresso, Getachew Aga, Andargachew Kumsa, Taye Letta, Saro Abdella, Shewki Moga, Mesay Hailu Dangisso, Getachew Tollera, Gemechu Tadesse
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716525000487
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author Getu Diriba
Ayinalem Alemu
Bazezew Yenew
Betselot Zerihun Ayano
Michael Hailu
Bedo Buta
Amanuel Wondimu
Zigba Tefera
Abyot Meaza
Getachew Seid
Muluwork Getahun
Biniyam Dagne
Hilina Mollalign
Yeshiwork Abebaw
Melak Getu
Mengistu Tadesse
Tegegn Belhu
Ephrem Alemu
Minilik Demissie
Ashenafi Erresso
Getachew Aga
Andargachew Kumsa
Taye Letta
Saro Abdella
Shewki Moga
Mesay Hailu Dangisso
Getachew Tollera
Gemechu Tadesse
author_facet Getu Diriba
Ayinalem Alemu
Bazezew Yenew
Betselot Zerihun Ayano
Michael Hailu
Bedo Buta
Amanuel Wondimu
Zigba Tefera
Abyot Meaza
Getachew Seid
Muluwork Getahun
Biniyam Dagne
Hilina Mollalign
Yeshiwork Abebaw
Melak Getu
Mengistu Tadesse
Tegegn Belhu
Ephrem Alemu
Minilik Demissie
Ashenafi Erresso
Getachew Aga
Andargachew Kumsa
Taye Letta
Saro Abdella
Shewki Moga
Mesay Hailu Dangisso
Getachew Tollera
Gemechu Tadesse
author_sort Getu Diriba
collection DOAJ
description 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 antituberculosis 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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series Journal of Global Antimicrobial Resistance
spelling doaj-art-b2a40a2ed0774a0192ecdcf222b570822025-08-20T03:48:51ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-05-014216717410.1016/j.jgar.2025.02.014Second-line drug resistance among multidrug-resistant tuberculosis patients in Ethiopia: A laboratory-based surveillanceGetu Diriba0Ayinalem Alemu1Bazezew Yenew2Betselot Zerihun Ayano3Michael Hailu4Bedo Buta5Amanuel Wondimu6Zigba Tefera7Abyot Meaza8Getachew Seid9Muluwork Getahun10Biniyam Dagne11Hilina Mollalign12Yeshiwork Abebaw13Melak Getu14Mengistu Tadesse15Tegegn Belhu16Ephrem Alemu17Minilik Demissie18Ashenafi Erresso19Getachew Aga20Andargachew Kumsa21Taye Letta22Saro Abdella23Shewki Moga24Mesay Hailu Dangisso25Getachew Tollera26Gemechu Tadesse27Ethiopian Public Health Institute, Addis Ababa, Ethiopia; Corresponding author. Mailing address: Ethiopian Public Health Institute, Addis Ababa, Ethiopia.Ethiopian Public Health Institute, Addis Ababa, Ethiopia; Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaMinistry of Health, National TB, Leprosy and other Lung Diseases Control Program, Addis Ababa, EthiopiaMinistry of Health, National TB, Leprosy and other Lung Diseases Control Program, Addis Ababa, EthiopiaMinistry of Health, National TB, Leprosy and other Lung Diseases Control Program, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaObjectives: 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 antituberculosis 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.http://www.sciencedirect.com/science/article/pii/S2213716525000487Extensively drug-resistant tuberculosisMultidrug-resistant tuberculosisPre-extensively drug-resistant
spellingShingle Getu Diriba
Ayinalem Alemu
Bazezew Yenew
Betselot Zerihun Ayano
Michael Hailu
Bedo Buta
Amanuel Wondimu
Zigba Tefera
Abyot Meaza
Getachew Seid
Muluwork Getahun
Biniyam Dagne
Hilina Mollalign
Yeshiwork Abebaw
Melak Getu
Mengistu Tadesse
Tegegn Belhu
Ephrem Alemu
Minilik Demissie
Ashenafi Erresso
Getachew Aga
Andargachew Kumsa
Taye Letta
Saro Abdella
Shewki Moga
Mesay Hailu Dangisso
Getachew Tollera
Gemechu Tadesse
Second-line drug resistance among multidrug-resistant tuberculosis patients in Ethiopia: A laboratory-based surveillance
Journal of Global Antimicrobial Resistance
Extensively drug-resistant tuberculosis
Multidrug-resistant tuberculosis
Pre-extensively drug-resistant
title Second-line drug resistance among multidrug-resistant tuberculosis patients in Ethiopia: A laboratory-based surveillance
title_full Second-line drug resistance among multidrug-resistant tuberculosis patients in Ethiopia: A laboratory-based surveillance
title_fullStr Second-line drug resistance among multidrug-resistant tuberculosis patients in Ethiopia: A laboratory-based surveillance
title_full_unstemmed Second-line drug resistance among multidrug-resistant tuberculosis patients in Ethiopia: A laboratory-based surveillance
title_short Second-line drug resistance among multidrug-resistant tuberculosis patients in Ethiopia: A laboratory-based surveillance
title_sort second line drug resistance among multidrug resistant tuberculosis patients in ethiopia a laboratory based surveillance
topic Extensively drug-resistant tuberculosis
Multidrug-resistant tuberculosis
Pre-extensively drug-resistant
url http://www.sciencedirect.com/science/article/pii/S2213716525000487
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