Experience on the first national anti-TB drug resistance survey(DRS)in Timor-Leste  

作　　者：Constantino Lopes Debashish Kundu Ismael Da Costa Barreto Bernardino da Cruz SSiva Kumar Sureshbabu Ramalingam Anna SDean Vineet Bhatia Prabhu Seenivasan CPadmapriyadarsini Olga Tosas Auguet 

机构地区：[1]National TB Programme,Ministry of Health,Dili,Timor-Leste [2]World Health Organization Country Office for Timor-Leste,Dili,Timor-Leste [3]National Health Laboratory,Ministry of Health,Dili,Timor-Leste [4]National HIV Programme,Ministry of Health,Dili,Timor-Leste [5]National Institute for Research in Tuber-culosis,Chennai,India [6]National TB Reference Laboratory,Dili,Timor-Leste [7]Global Tuberculosis Programme,World Health Organization,Geneva,Switzerland [8]World Health Organization South East Asia Regional Office,New Delhi,India

出　　处：《Global Health Research and Policy》2022年第1期415-423,共9页全球健康研究与政策（英文）

摘　　要：Background:A national drug resistance survey(DRS)was implemented for the first time in Timor-Leste(TL)in 2019.The primary objective of the survey was to assess the prevalence of drug resistance among new and previously treated pulmonary TB patients in the country.Methods:This nation-wide cross-sectional survey was conducted in 2019 targeting all new and previously treated sputum smear-positive pulmonary TB patients.Sputum samples were submitted to the National TB Reference Laboratory for confirmation of TB and to determine resistance to rifampicin by Xpert MTB/RIF.Culture was performed on solid media,and culture isolates of confirmed TB cases were shipped to the WHO Supranational TB Reference Laboratory in Chennai,India for whole genome sequencing(WGS).Survey summary statistics,data cross-tabulations and analysis of potential risk factors of rifampicin-resistant TB(RR-TB)were conducted using R statistical software(version 3.5.2).Results:A total of 953 sputum-smear positive patients were enrolled,of which 917 were confirmed as positive for TB by either Xpert MTB/RIF or culture.An electronic web-based system was used for entry and storage of the data.Rifampicin resistance was detected among 0.6%(95%CI 0.2-1.3)of new cases and 2.7%(95%CI 0.5-8.2)of previously treated cases.WGS was conducted for validation purposes on 65 randomly selected isolates(29%of RR-TB(2/7)and 7%of RS-TB(63/910)by Xpert MTB/RIF or pDST).The original test results agreed with the WGS validation results for 62/64 isolates(97%).Conclusion:The prevalence of RR-TB in Timor-Leste is relatively low compared to the estimated proportions of RR-TB in the WHO South-East Asia Region(2.5%[95%CI 1.9-3.3]among new cases and 14%[95%CI 7.7-21]among previously treated cases).The rapid sputum collection and transportation mechanism implemented in the survey demonstrates its feasibility in low resource settings and should be replicated for routinely transporting TB specimens from microscopy labs to GeneXpert sites.Establishment of in-country capacity for rapid mol

关 键 词：Anti-TB Drug Resistance Survey Rifampicin resistance Whole genome sequencing TIMOR-LESTE 

分 类 号：R52[医药卫生—内科学]