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2005
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TUBERCULOSIS
Al-Akhali A, Ohkado A, Fujiki A, Mitarai S, Yamada N, Masui T, Otomo K,
Yamada H, Seita A, Mori T, Al-Absi AN. Nationwide survey on the prevalence of
anti-tuberculosis drug resistance in the Republic of Yemen, 2004.
International Journal of Tuberculosis and Lung Disease 11(12), 1328-33,
2007.
OBJECTIVES: To determine the prevalence of resistance to the four major
anti-tuberculosis drugs, isoniazid, rifampicin, streptomycin and ethambutol, in
Yemen. METHODS: Cluster sampling with probability proportionate to size was
applied. Susceptibility to four major anti-tuberculosis drugs was examined. The
proportion method using Löwenstein-Jensen medium or Ogawa medium was carried
out. RESULTS: A total of 790 primary culture isolates from tuberculosis (TB)
cases enrolled at the National Tuberculosis Institute, Yemen, were examined. In
the confirmation culture at the supranational reference laboratory, 227 of them
failed to grow on the secondary culture or were proved to be mycobacteria other
than Mycobacterium tuberculosis and were excluded from further analysis. Among
563 cultures, 510 were obtained from new cases and 53 from previously treated
cases. The prevalence of resistance to any four drugs was 9.8% (95%CI 7.0-12.5)
among new cases and 17.4% (95%CI 12.0-33.5) among previously treated cases. The
prevalence of multidrug-resistant TB was 3.0% (95%CI 1.5-4.5) among new cases
and 9.4% (95%CI 0.2-18.7) among previously treated cases. CONCLUSION: The first
nationwide prevalence survey on resistance to the four major anti-tuberculosis
drugs in Yemen showed a relatively low prevalence of drug-resistant cases, but a
high prevalence of multidrug resistance among new cases.
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