Epidemiological and clinical profile of rifampicin-sensitive and -resistant pulmonary tuberculosis in sites of displaced persons due to the 2022-2024 floods in N'Djamena, Chad
Abstract
Patients with rifampicin-resistant tuberculosis (RR-TB) may remain a source of infection longer than rifampicin-susceptible tuberculosis (RS-TB). The objective of this study was to detect active cases of rifampicin-susceptible and -resistant tuberculosis in displaced persons sites in the 9th District of N’Djamena.
This observational, cross-sectional and analytical study was conducted among 418 contacts of the displaced persons, including 285 in the Walia site and 133 in the Toukra site. Data were collected using a pre-tested, semi-structured questionnaire administered by an interviewer. The identification of active cases of tuberculosis among the displaced persons was carried out by an interview to verify the presence or absence of TB symptoms. The TB-LAMP molecular technique was used to detect active tuberculosis among symptomatic and asymptomatic contacts. Instead, a GeneXpert analysis was carried out to detect cases of tuberculosis sensitive and resistant to rifampicin.
TB-LAMP detected 76 (5.5%) cases of active TB among 418 displaced persons, including 11 lost to follow-up and 65 new cases. Female patients were more dominant (59.21%) than males (40.78%), and the age of patients ranged from 12 to 65 years, with a mean age of 38.5 years with a sex ratio of 1.45 in favor of females. Loss of appetite (31%), asthenia (20.0%) and cough (16%) were the most common symptoms.
GeneXpert confirmed the 76 positive cases of Mycobacterium tuberculosis, of which 8 (10.52%) were resistant and 69 (90.78%) were sensitive to rifampicin.
HIV1/2 immunochromatographic tests detected 12 (15.78%) cases of HIV/tuberculosis coinfection among the positive cases.
This study highlighted the emergence of strains of the Mycobacterium tuberculosis complex resistant and sensitive to rifampicin.
Regular and effective screening of RR-TB contacts is necessary to stop transmission in displaced persons sites in Chad, Africa and even worldwide.
Keywords: Flood, displaced person, Mycobacterium tuberculosis, resistance, rifampicin, molecular technique, Chad.
Keywords:
Flood, displaced person, Mycobacterium tuberculosis, resistance, rifampicin, molecular technique, ChadDOI
https://doi.org/10.22270/jddt.v15i1.6962References
1. World Health Organization, Annu Global TB Report,2022:1-68. Available: https://www.who.int/publications/i/item/9789240061729.
2. World Health Organization, Optimizing active case-finding for tuberculosis Implementation lessons from South-East Asia, 2021. Available: https://www.who.int/publications/i/item/9789290228486
3. World Health Organization, Tuberculosis report, 2023. Available from: https.//www.who.int/news-room/fact-sheets/detail/tuberculosis.
4. Mulder C, Klinkenberg E, Manissero D, Effectiveness of tuberculosis contact tracing among migrants and the foreign-born population, Euro Surveill 2009. https://doi.org/10.2807/ese.14.11.19153-en PMid:19317977
5. World Health Organization, Using the Xpert MTB/RIF assay to detect pulmonary and extrapulmonary tuberculosis and rifampicin resistance in adults and children, 2019. Available: http://www.who.int/tb/publications/xpert-mtb-rif-assay-diagnosis-meeting-report/en/.
6. World Health Organization, treatment guidelines for drug resistant tuberculosis.U.S, Agency for International Development, 2011: Audit of USAID/GHANA'S tuberculosis program. 2016.
7. Sekhawat V, Lucas SB, Re‐emergent yellow fever: New faces of an old killer. Histopathology, 2019 ;75(5):636-637. https://doi.org/10.1111/his.13939 PMid:31643117
8. World Health Organization, Implementing the end TB strategy: The essentials, 2015.
9. USAID, Bangladesh tuberculosis roadmap overview, fiscal year 2021,2022. https://www.usaid.gov/sites/default/files/2022-
10. Stevens WS, Cunningham B, Cassim N, Gous N, Scott L, Cloud based surveillance GeneXpert analyzers for diagnosis of tuberculosis (TB) and multiple-drug-resistant TB. In Persing DH (ed), Molecular Microbiology: Diagnostic Principles and Practice, 2016;3rd ed. ASM Press, Washington DC.
11. Kedaï E, Incidence of tuberculosis in Chad in 2022, 2023. https://www.google.com
12. OCHA/ONU (UN Office for the Coordination of Humanitarian Affairs), Floods in Chad 2022-2024, 2022. https://www.unep.org/en/browse-topics/water
13. Reichler MR, Khan A, Yuan Y, Chen B, McAuley J, Mangura B, et al., Duration of Exposure Among Close Contacts of Patients with Infectious Tuberculosis and Risk of Latent Tuberculosis Infection, Clin. Infect. Dis, 2020; 71:1627. https://doi.org/10.1093/cid/ciz1044 PMid:32044987 PMCid:PMC8851607
14. World Health Organization, Optimizing active case-finding for tuberculosis Implementation lessons from South-East Asia, 2021. Available: https://www.who.int/publications/i/item/9789290228486
15. Dejene TA, Genet GH, Atsebaha GK, Araya GW, Pulmonary Tuberculosis and Rifampicin Resistant Mycobacterium Tuberculosis in Children and Adolescents using Gene Xpert MTB/RIF Assay in Tigray, Northern Ethiopia, Infection and Drug Resistance, 2023; 16: 6757-6776. https://doi.org/10.2147/IDR.S433789 PMid:37876859 PMCid:PMC10591601
16. World Health Organization, Using the Xpert MTB/RIF assay to detect pulmonary and extrapulmonary tuberculosis and rifampicin resistance in adults and children, 2019. available: http://www.who.int/tb/publications/xpert-mtb-rif-assay-diagnosis-meeting-report/en/.
17. Alimuddin Z, Ibrahim A, Improving access to multi-drug-resistant tuberculosis diagnostic and health services for refugees and migrants, BMC Medicine, 2018; 16 (221):1-4. https://doi.org/10.1186/s12916-018-1218-0 PMid:30497477 PMCid:PMC6267830
18. Arega B, Menbere F, Getachew Y, Prevalence of rifampicin resistant Mycobacterium tuberculosis among presumptive tuberculosis patients in selected governmental hospitals in Addis. BMC Infect Dis, 2019;19 (1):1-5. https://doi.org/10.1186/s12879-019-3943-1 PMid:30947695 PMCid:PMC6449910
19. Workalemahu B, Berg S, Tsegaye W, et al., Genotype diversity of Mycobacterium isolates from children in Jimma, Ethiopia, BMC Res Notes; 2013; 6 (1) :0-6. https://doi.org/10.1186/1756-0500-6-352 PMid:24007374 PMCid:PMC3766673
20. Cepheid. GeneXpertDx System Users' manual, 2012:2-13.
21. Bates M, O'Grady J, Maeurer M, et al., Assessment of the Xpert MTB/RIF assay for diagnosis of tuberculosis with gastric lavage aspirates in children in sub-Saharan Africa: a prospective descriptive study, Lancet Infect Dis 2013;13(1):36-44. https://doi.org/10.1016/S1473-3099(12)70245-1 PMid:23134697
22. Reither K, Manyama C, Clowes P, et al. Xpert MTB/RIF assay for diagnosis of pulmonary tuberculosis in children: a prospective, multi-center evaluation, J Infect, 2015 ;70(4) :392-399. https://doi.org/10.1016/j.jinf.2014.10.003 PMid:25312863
23. Aazri L, Aitbatahar S, Amro L, Risk factors and diagnosis of tuberculosis, Rev Mal Respir Actual, 2020; 12 (1): 264. https://doi.org/10.1016/j.rmra.2019.11.598
24. Programme National de lutte contre la Tuberculose, Key recommendations for the fight against tuberculosis, 2017:16 p. https://www.alwihdainfo.com.
25. Isca D, Ong CWM, Tiberi S, Centis R, D'Ambrosio L, Chen B, et al., Tuberculosis and COVID-19 interaction: A review of biological, clinical and public health effects, Pulmonology 2021; 27:151-65. https://doi.org/10.1016/j.pulmoe.2020.12.012 PMid:33547029 PMCid:PMC7825946
26. Shadrach BJ, Kumar S, Deokar K, Singh GV, Hariharan, Goel R. A study of multidrug resistant tuberculosis among symptomatic household contacts of MDR-TB patients, Indian J Tuberc; 2021. https://doi.org/10.1016/j.ijtb.2020.09.030 PMid:33641847
27. Elmadhooun WM, Prevalence of tuberculosis among children in North Sudan: are we only seeing the tip of the iceberg?, J Nat Sc Biol Med, 2017 ; 8 :114-118. https://doi.org/10.4103/0976-9668.198359 PMid:28250686 PMCid:PMC5320812
28. Arega B, Menbere F, Getachew Y, Prevalence of rifampicin resistant Mycobacterium tuberculosis among presumptive tuberculosis patients in selected governmental hospitals in Addis, BMC Infect Dis, 2019;19(1):1-5. https://doi.org/10.1186/s12879-019-3943-1 PMid:30947695 PMCid:PMC6449910
29. Workalemahu B, Berg S, Tsegaye W, et al., Genotype diversity of Mycobacterium isolates from children in Jimma, Ethiopia, BMC Res Notes, 2013;6(1):0-6. https://doi.org/10.1186/1756-0500-6-352 PMid:24007374 PMCid:PMC3766673
30. Timire C, Metcalfe JZ, Chirenda J, et al., Prevalence of drug-resistant tuberculosis in Zimbabwe: a health facility-based cross-sectional survey, Int Soc Infect Dis, 2019;87:119-125. https://doi.org/10.1016/j.ijid.2019.07.021 PMid:31357057 PMCid:PMC9586843
31. Bennett, R. J., Brodine, S., Waalen, J., Moser, K., & Rodwell, T. C, Prevalence and treatment of latent tuberculosis infection among newly arrived refugees in San Diego County, January 2010-October 2012, American Journal of Public Health, 2014; 104(4): e95-e102. https://doi.org/10.2105/AJPH.2013.301637 PMid:24524534 PMCid:PMC4025726
32. Bernard, D, Immigrant clients in Lanaudière : received immigrants, refugees, temporary immigrants, etc. Are they all at risk of the same health problems?, Le Prévenant ; 2014 23(14): 3. Retrieved from http://www.cisss-lanaudiere.gouv.qc.ca/documentation/sante-publique/bulletins/le-prevenant/ .
33. F.Z. Mrabet, M. Soualhi, R. Zahraoui, K. Marc, J. Benamor, J.E. Bourkadi, The aspect of tuberculosis in the prison environment, Respiratory Diseases Review, 2019; 36: A250 Supplement. https://doi.org/10.1016/j.rmr.2018.10.578
34. H. Bah, F.A. Cisse, L.M. Camara, O.H. Diallo, M. Diallo, O.Y. Sow, Prevalence of tuberculosis in prisons in Conakry, Republic of Guinea, 2012; 3 (4):146-150 - December 2012 https://doi.org/10.1016/j.medleg.2012.06.003
35. Rakotomanana F, Dreyfus A, Raberahona M, Chevallier E, Randrianarisoa MM, Andrianasy HE, Bernardson B, Ranaivomanana P, Raitsilanihasy F, Rasoamaharo M, Randrianirisoa SAN, Rakotosamimanana N, Baril L, Randremanana RV, Prevalence of tuberculosis and HIV infection in prison settings, Antananarivo Madagascar, 2022; 70 (Supplement 3): S194-S195. https://doi.org/10.1016/j.respe.2022.06.180
Published
Abstract Display: 34 
PDF Downloads: 20 PDF Downloads: 3 How to Cite
Issue
Section
Copyright (c) 2025 Djimenan Boilengar , Togde Gildas le Djimbaye , Nadlaou Bessimbaye , Keloumta Mantangar Clarisse, Rimtebaye Kimassoum
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
How to Cite
.