Anti-tuberculosis drug resistance survey in West Nile, Uganda

• Multidrug resistance (MDR) in HIV co-infected patients • Increase of nosocomial transmission • High case fatality rate • MDR poorly documented in Sub-Saharan countries where majority of TB cases are HIV co-infected • Emergence of MDR and Extreme-drug resistance (XDR) epidemics in Kwazulu Natal (Gandhi et al, Lancet.2006) • MDR-TB likely to be underestimated • North western Uganda National adult HIV prevalence rate was of 6.7% in 2005 Drug Susceptibility Testing survey in Uganda ○ 1996-97 (national): 0.5% MDR prevalence in new cases (NC) and 4.4% in previously treated cases (PTC) ○ 2000 (hospital-based study in Kampala): 4.7% MDR TB in NC, among those 70% HIV co-infected • HIV and TB program supported by Medecins Sans Frontieres in West Nile region (north-western Uganda) MDR treatment available in Arua regional referral Hospital