ArticleBMC medicine2016
The emerging threat of pre-extensively drug-resistant tuberculosis in West Africa: preparing for large-scale tuberculosis research and drug resistance surveillance.
Article in BMC medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Global prevalence of drug-resistant tuberculosis: a systematic review and meta-analysis.Infectious diseases of poverty · 2023Pooled it
- Treatment outcomes and antiretroviral uptake in multidrug-resistant tuberculosis and HIV co-infected patients in Sub Saharan Africa: a systematic review and meta-analysis.BMC infectious diseases · 2019Pooled it
- Prevalence of drug-resistant tuberculosis in Nigeria: A systematic review and meta-analysis.PloS one · 2017Pooled it
- Drug resistance profile and species diversity in tuberculosis mycobacteria isolated from patients with presumptive tuberculosis in Brazzaville, Republic of Congo.IJID regions · 2026Article
- Drug resistance patterns and associated risk factors in pulmonary tuberculosis patients from selected hospitals in Ghana.BMC infectious diseases · 2026Article
- Addressing key risk factors hindering tuberculosis control activities in West Africa - progress in meeting the UN sustainable development goals.IJID regions · 2025Review
- Defying barriers to fight tuberculosis in West Africa: a model of equitable partnerships within a research capacity-strengthening network in the subregion.Frontiers in public health · 2025Article
- Opinion review of drug resistant tuberculosis in West Africa: tackling the challenges for effective control.Frontiers in public health · 2024Review
- Mycobacterium tuberculosis complex drug-resistance, phylogenetics, and evolution in Nigeria: Comparison with Ghana and Cameroon.PLoS neglected tropical diseases · 2023Review
- Tuberculosis and Migrant Pathways in an Urban Setting: A Mixed-Method Case Study on a Treatment Centre in the Lisbon Metropolitan Area, Portugal.International journal of environmental research and public health · 2022Article
- Distribution of HbS Allele and Haplotypes in a Multi-Ethnic Population of Guinea Bissau, West Africa: Implications for Public Health Screening.Frontiers in pediatrics · 2022Article
- Molecular epidemiology and multidrug resistance ofHeliyon · 2021Article
- Early detection of Pre-XDR TB with line probe assay in a high TB burden country.African health sciences · 2021Article
- The Relevance of Genomic Epidemiology for Control of Tuberculosis in West Africa.Frontiers in public health · 2021Review
- Understanding the gaps in DR-TB care cascade in Nigeria: A sequential mixed-method study.Journal of clinical tuberculosis and other mycobacterial diseases · 2020Article
- Institutional Approaches to Research Integrity in Ghana.Science and engineering ethics · 2020Review
- Evolution of Mycobacterium tuberculosis complex lineages and their role in an emerging threat of multidrug resistant tuberculosis in Bamako, Mali.Scientific reports · 2020Article
- Comparative genomics shows differences in the electron transport and carbon metabolic pathways of Mycobacterium africanum relative to Mycobacterium tuberculosis and suggests an adaptation to low oxygen tension.Tuberculosis (Edinburgh, Scotland) · 2020Article
- Adenoviral vector-based vaccine is fully protective against lethal Lassa fever challenge in Hartley guinea pigs.Vaccine · 2019Article
- Multidrug-Resistant Tuberculosis in Burkina Faso from 2006 to 2017: Results of National Surveys.European journal of microbiology & immunology · 2019Article
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Authors and funding
44 authors at 16 institutions in 11 countries.
Funding
Abstract
backgroundDrug-resistant tuberculosis (TB) is a global public health problem. Adequate management requires baseline drug-resistance prevalence data. In West Africa, due to a poor laboratory infrastructure and inadequate capacity, such data are scarce. Therefore, the true extent of drug-resistant TB was hitherto undetermined. In 2008, a new research network, the West African Network of Excellence for Tuberculosis, AIDS and Malaria (WANETAM), was founded, comprising nine study sites from eight West African countries (Burkina Faso, The Gambia, Ghana, Guinea-Bissau, Mali, Nigeria, Senegal and Togo). The goal was to establish Good Clinical Laboratory Practice (GCLP) principles and build capacity in standardised smear microscopy and mycobacterial culture across partnering laboratories to generate the first comprehensive West African drug-resistance data.
methodsFollowing GCLP and laboratory training sessions, TB isolates were collected at sentinel referral sites between 2009-2013 and tested for first- and second-line drug resistance.
resultsFrom the analysis of 974 isolates, an unexpectedly high prevalence of multi-drug-resistant (MDR) strains was found in new (6 %) and retreatment patients (35 %) across all sentinel sites, with the highest prevalence amongst retreatment patients in Bamako, Mali (59 %) and the two Nigerian sites in Ibadan and Lagos (39 % and 66 %). In Lagos, MDR is already spreading actively amongst 32 % of new patients. Pre-extensively drug-resistant (pre-XDR) isolates are present in all sites, with Ghana showing the highest proportion (35 % of MDR). In Ghana and Togo, pre-XDR isolates are circulating amongst new patients.
conclusionsWest African drug-resistance prevalence poses a previously underestimated, yet serious public health threat, and our estimates obtained differ significantly from previous World Health Organisation (WHO) estimates. Therefore, our data are reshaping current concepts and are essential in informing WHO and public health strategists to implement urgently needed surveillance and control interventions in West Africa.
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