Phenotypic drug resistance and genetic mutations linked to resistance among extrapulmonary tuberculosis patients in Ethiopia: Insights from Whole Genome Sequencing
2024

Drug Resistance and Genetic Mutations in Extrapulmonary Tuberculosis Patients in Ethiopia

Sample size: 189 publication 10 minutes Evidence: high

Author Information

Author(s): Mollalign Hilina, Alemayehu Dawit Hailu, Beyene Dereje, Melaku Kalkidan, Ayele Abaysew, Chala Dawit, Diriba Getu, Yenew Bazezew, Getahun Muluwork, Adnew Bethlehem, Moga Shewki, Collins Jeffrey Michael, Ghodousi Arash, Bobosha Kidist, Wassie Liya

Primary Institution: Ethiopian Public Health Institute

Hypothesis

What is the magnitude of phenotypic drug resistance and the genetic mutations linked to resistance in extrapulmonary tuberculosis patients in Ethiopia?

Conclusion

MDR-TB, Hr-TB, and interim-RMR-TB are significant public health challenges in Ethiopia, with whole genome sequencing playing a crucial role in detecting these conditions.

Supporting Evidence

  • 16.9% of study participants showed phenotypic resistance to at least one anti-TB drug.
  • MDR-TB prevalence was 2.4% among newly diagnosed and 21.1% among previously treated cases.
  • WGS identified more rifampicin-resistant genotypes compared to phenotypic testing.
  • 3.75% of the study population had rifampicin mono-resistant-TB that was undetected by conventional methods.
  • Changes in ethA genes associated with ethionamide resistance were common in MDR-TB cases.

Takeaway

This study looked at how some tuberculosis patients in Ethiopia are resistant to drugs, finding that many have mutations that make treatment harder.

Methodology

A cross-sectional study was conducted using 189 Mycobacterium tuberculosis isolates from extrapulmonary clinical specimens, with phenotypic drug sensitivity testing and whole genome sequencing performed.

Limitations

The study lacks data on treatment outcomes and the characterization of protein structures of reported compensatory mutations.

Participant Demographics

The mean age of participants was 32 years, with 54% being male.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI: 30–34 years

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.21203/rs.3.rs-5302564

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