[Multidrug-resistant tuberculosis (MDR-TB) in a black African carceral area: Experience of Mali]

Rev Pneumol Clin. 2018 Feb;74(1):22-27. doi: 10.1016/j.pneumo.2017.10.005. Epub 2017 Dec 13.
[Article in French]

Abstract

Introduction: Prison constitutes a risk factor for the emergence of multi-drug resistance of tuberculosis (MDR-TB). The aim of this work was to study MDR-TB in a black African carceral center.

Material and methods: Prospective study from January to December 2016 at the central house of arrest for men, Bamako. The study population was composed of tuberculous detainee. The suspicion of MDR-TB was done in any tuberculosis case remained positive in the second month of first-line treatment or in contact with an MDR-TB case.

Result: Among 1622 detainee, 21 cases of pulmonary tuberculosis were notified (1.29%), with an annual incidence of 13 cases/1000 detainee, they were 16 cases of SP-PTB (microscopy smear positive tuberculosis) and five cases of microscopy smear negative tuberculosis. The mean age was 28±7 years, extremes of 18 and 46 years. A negative association was found between the notion of smoking and occupation in the occurrence of tuberculosis (OR=0.036, [95% CI: 0.03-0.04], P=0.03. Among the 21 tuberculosis cases notified, one confirmed case of MDR-TB was detected (4.7%). In the first semester of 2016 cohort, we notified a cure rate of 87.5% (7/8 SP-PTB cases), and the confirmed MDR-TB case on treatment (21-month regimen), evolution enameled of pulmonary and hearing sequelae at seven months treatment.

Conclusion: It was the first case of MDR-TB detected in a prison in Mali. Late diagnosis, evolution is enameled of sequelae and side effects.

Keywords: Mali; Multi-résistance; Multidrug-resistance; Prison; Traitement; Treatment; Tuberculose; Tuberculosis.

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / therapeutic use*
  • Black or African American
  • Humans
  • Incidence
  • Male
  • Mali / epidemiology
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Prisons / statistics & numerical data
  • Prospective Studies
  • Risk Factors
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / ethnology*
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / ethnology*
  • Young Adult

Substances

  • Antitubercular Agents