Multi drug resistant tuberculosis in Mosango, a rural area in the Democratic Republic of Congo

PLoS One. 2014 Apr 14;9(4):e94618. doi: 10.1371/journal.pone.0094618. eCollection 2014.

Abstract

Multidrug Resistant Tuberculosis (MDR-TB) is a serious threat which jeopardizes the worldwide efforts to control TB. The Democratic Republic of Congo (DRC) is one of 27 countries with a high burden of MDR-TB. Data on the magnitude, trends, and the distribution of MDR-TB in DRC are scanty. Kinshasa, the capital city of DRC which accounts for 20% of all TB cases nationwide, is notifying more than 80% of all MDR suspects. We report here a cluster of MDR-TB cases that was investigated in the Mosango health district, in the Bandundu south Province, DRC in 2008. Phenotypic Drug Sensitivity Testing and DNA sequencing were performed on 18 sputum specimens collected from 4 MDR-TB suspects and 5 household contacts. Sequencing data confirmed that the 4 suspects were indeed Rifampicin resistant cases. Sequencing of the rpoB gene showed that 3 cases (patients A, B and D) had a single mutation encoding a substitution to 526Tyr, 531Trp and 526Leu respectively. Patient C had a double mutation encoding a change to 531Leu and 633Leu. Two of the investigated cases died within 4 months of a second-line treatment course. Results highlight the need to enhance adequate laboratory services within the country for both clinical as well as surveillance purposes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use*
  • Bacterial Proteins / genetics
  • Child
  • Cluster Analysis
  • DNA-Directed RNA Polymerases
  • Democratic Republic of the Congo / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Phenotype
  • Rifampin / therapeutic use
  • Rural Population
  • Sequence Analysis, DNA
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / epidemiology
  • Young Adult

Substances

  • Antitubercular Agents
  • Bacterial Proteins
  • rpoB protein, Mycobacterium tuberculosis
  • DNA-Directed RNA Polymerases
  • Rifampin

Grants and funding

The field visit in Mosango Health District was funded by the National TB Program grant 5 supported by The Global Fund to Fight AIDS, Tuberculosis and Malaria, 8 Chemin de Blandonnet, 1214 Vernier, Geneva, Switzerland. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.