TITLE:
The Contribution of the Xpert® MTB/RIF Assay to the Surveillance of Drug-Resistant Tuberculosis in the Central African Republic
AUTHORS:
Alain Farra, Lydie V. Danebera, Gilles Ngaya, Brice M. Yambiyo, Alexandre Manirakiza, Christian D. Mossoro-Kpinde
KEYWORDS:
Xpert® MTB/RIF Assay, Rifampicin, Surveillance, CAR
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.11 No.1,
March
7,
2023
ABSTRACT: Introduction: The Central African Republic is one of the 30 high
Tuberculosis burden countries in the world, with an incidence of 540 cases per
100,000 population and a mortality of 91 deaths per 100,000 population. Since
2020, following WHO recommendations, the
National Reference Laboratory for Tuberculosis has been using the Xpert® MTB/RIF assay as a first-line diagnostic test
for the early detection of Drug Resistance Tuberculosis.
The goal of this study was to evaluate the contribution of
the Xpert® MTB/RIF assay to the surveillance of
rifampicin resistance in new and previously treated tuberculosis cases. Materials and Methods: The
data relative to the Xpert® MTB/RIF assay carried out on various categories of
tuberculosis patients registered at the National Reference Laboratory for
Tuberculosis in 2020 were analyzed retrospectively. The
categories of tuberculosis patients were new cases, failed treatment cases,
relapse cases, lost-to-follow-up cases and multidrug-resistant tuberculosis contact cases. Results: A
total of 1404 tuberculosis patients were registered at the NRL-TB in 2020; the
mean age was 39.2 years (2 - 90 years) and the male-to-female sex ratio
was 1.16:1. Overall, 32.7% (454/1404) proved infected with tuberculosis, of which
22.5% (102/454) cases showed resistance to rifampicin. The primary resistance
rate was 9.1% (27/298) and the secondary resistance
rate was 46.6% (75/161). Treatment failures and relapsed cases were significantly associated with rifampicin resistance
(p 0.005). Conclusion: Large-scale use of Xpert® MTB/RIF, especially in the provinces of the Central African Republic, will help
the Ministry of Health to better control Drug Resistance Tuberculosis in the
country.