Emergence and clonal transmission of multi-drug-resistant tuberculosis among patients in Chad.
BACKGROUND
Emergence of Multidrug-resistant (MDR) strains constitutes a significant public health problem worldwide. Prevalence of MDR tuberculosis from Chad is unavailable to date.


METHODS
We collected samples from consecutive TB patients nationwide in the seven major cities of Chad between 2007 and 2012 to characterize drug resistance and the population structure of circulating Mycobacterium tuberculosis complex (MTBC) strains. We tested drug sensitivity using Line Probe Assays and phenotypic drug susceptibility testing (DST) were used for second line drugs. We genotyped the isolates using spoligotype analysis and MIRU-VNTR.


RESULTS
A total of 311 cultures were isolated from 593 patients. The MDR prevalence was 0.9% among new patients and 3.5% among retreatment patients, and no second line drug resistance was identified. The distribution of genotypes suggests a dissemination of MDR strains in the Southern city of Moundou, bordering Cameroon and Central African Republic.


CONCLUSION
Emerging MDR isolates pose a public health threat to Southern Chad, with risk to neighboring countries. This study informs public health practitioners, justifying the implementation of continuous surveillance with DST for all retreatment cases as well as contacts of MDR patients, in parallel with provision of adequate 2nd line regimens in the region.
['Ba Diallo|Awa|A|0000-0003-3485-9828', 'Ossoga|Gedeon W|GW|', 'Daneau|Geraldine|G|', 'Lo|Seynabou|S|', 'Ngandolo|Richard|R|', 'Djaibé|Colette Diguimbaye|CD|', 'Djouater|Barou|B|', 'Mboup|Souleymane|S|', 'de Jong|Bouke C|BC|', 'Diallo|Aissatou G|AG|', 'Gehre|Florian|F|']
D000995:Antitubercular Agents D002596:Chad D002999:Clone Cells D021821:Communicable Diseases, Emerging D024901:Drug Resistance, Multiple, Bacterial D005260:Female D014644:Genetic Variation D005838:Genotype D006801:Humans D008297:Male D008875:Middle Aged D009169:Mycobacterium tuberculosis D015995:Prevalence D018088:Tuberculosis, Multidrug-Resistant
Chad MDR Mycobacterium tuberculosis Molecular characterization