Evidence map›Paper›PMID 25658921›Full record

ArticlePloS one2015

Low resistance to first and second line anti-tuberculosis drugs among treatment naive pulmonary tuberculosis patients in southwestern Uganda.

Patrick Orikiriza, Becky Tibenderana, Mark J Siedner, Yolanda Mueller, Frederick Byarugaba, Christopher C Moore, Emily E Evans, Maryline Bonnet, Anne-Laure Page, Joel Bazira and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Second line drug susceptibility testing to inform the treatment of rifampin-resistant tuberculosis: a quantitative perspective.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2017
    Review
  4. GenoTypeThe Cochrane database of systematic reviews · 2016
    Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Patrick OrikirizaEpicentre Mbarara Research Centre, Mbarara, Uganda; Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda.
Becky TibenderanaDepartment of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Mark J SiednerDepartment of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, United States of America.
Yolanda MuellerEpicentre Mbarara Research Centre, Mbarara, Uganda.
Frederick ByarugabaDepartment of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda.
Christopher C MooreDepartment of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America.
Emily E EvansDepartment of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America.
Maryline BonnetEpicentre Paris, Paris, France.
Anne-Laure PageEpicentre Paris, Paris, France.
Joel BaziraDepartment of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda.
Yap BoumEpicentre Mbarara Research Centre, Mbarara, Uganda; Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda.
Mbarara University of Science and Technology · UGEpicentre Uganda · UGMassachusetts General Hospital · USUniversity of Virginia · US

Funding

Medical Education for Services to All Ugandans (MESAU)R24TW008886 · FIC · MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI SEWANKAMBO, NELSON K · 2010 to 2015
$9.2M
Behavioral Aspects of Low-cost Medical Devices to Improve HIV CareK23MH099916 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI SIEDNER, MARK J · 2013 to 2017
$917k
FIC NIH HHS 5R24TW008886FIC NIH HHS R24 TW008886NIMH NIH HHS K23 MH099916
6 · The paper itself

Abstract

backgroundThere are limited data on region-specific drug susceptibility of tuberculosis (TB) in Uganda. We performed resistance testing on specimens collected from treatment-naive patients with pulmonary TB in Southwestern Uganda for first and second line anti-TB drugs. We sought to provide data to guide regional recommendations for empiric TB therapy.

methodsArchived isolates, obtained from patients at Mbarara Regional Referral Hospital from February 2009 to February 2013, were tested for resistance to isoniazid and rifampicin using the MTBDRplus and Xpert MTB/RIF assays. A subset of randomly selected isolates was tested for second line agents, including fluoroquinolones (FQs), aminoglycosides, cyclic peptides, and ethambutol using the MTBDRsl assay. We performed confirmatory testing for FQ resistance using repeated MTBDRsl, the Mycobacteria growth indicator tube (MGIT) assay, and sequencing of the gyrA and gyrB genes.

resultsWe tested isolates from 190 patients. The cohort had a median age of 33 years (IQR 26-43), 69% (131/190) were male, and the HIV prevalence was 42% (80/190). No isolates (0/190) were rifampicin-resistant and only 1/190 (0.5%) was isoniazid-resistant. Among 92 isolates tested for second-line drug resistance, 71 (77%) had interpretable results, of which none were resistant to aminoglycosides, cyclic peptides or ethambutol. Although 7 (10%) initially tested as resistant to FQs by the MTBDRsl assay, they were confirmed as susceptible by repeat MTBDRsl testing as well as by MGIT and gyrase gene sequencing.

conclusionWe found no MDR-TB and no resistance to ethambutol, FQs, or injectable anti-TB drugs in treatment naïve patients with pulmonary TB in Southwestern Uganda. Standard treatment guidelines for susceptible TB should be adequate for most patients with TB in this population. Where possible, molecular susceptibility testing methods should be routinely validated by culture methods.

Indexed as

Drug Resistance, BacterialAdultAntitubercular AgentsFemaleHumansMaleMicrobial Sensitivity TestsMycobacterium tuberculosisTuberculosis, PulmonaryUgandaAntitubercular Agents

Identifiers

PMID25658921
PMCPMC4320102
OpenAlexW2134698288

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.