Drug-resistant pulmonary tuberculosis in a cohort of southern African goldminers with a high prevalence of HIV infection.
S Afr Med J
; 90(4): 381-6, 2000 Apr.
Article
en En
| MEDLINE
| ID: mdl-10957924
ABSTRACT
OBJECTIVES:
To determine rates of drug resistance to Mycobacterium tuberculosis and associated risk factors, including HIV infection.DESIGN:
Prospective cohort study of patients with pulmonary tuberculosis.SETTING:
The study population comprised 28,522 men working on four goldmines in Westonaria, Gauteng. Health care is provided at a 240-bed mine hospital, Gold Fields West Hospital, and its primary health care facilities.SUBJECTS:
All 425 patients with culture-positive pulmonary tuberculosis identified in 1995. OUTCOMEMEASURES:
Tuberculosis drug resistance on enrollment and after 6 months' treatment.RESULTS:
There were 292 cases of new tuberculosis, 77 of recurrent disease and 56 prevalent cases in treatment failure. Two hundred and seven patients (48.7%) were HIV infected. Primary resistance to one or more drugs (9%) was similar to the 11% found in a previous study done on goldminers in 1989. Primary multidrug resistance (0.3%) was also similar (0.8%). Acquired multidrug resistance was 18.1% 6.5% for recurrent disease and 33.9% in treatment failure cases. Neither HIV infection nor the degree of immunosuppression as assessed by CD4+ lymphocyte counts was associated with drug resistance at the start or end of treatment. New patterns of drug resistance were present in 9 of 52 patients in treatment failure at 6 months, 1 of whom was HIV-infected.CONCLUSION:
Primary and acquired drug resistance rates are stable in this population and are not affected by the high prevalence of HIV infection.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Seropositividad para VIH
/
Infecciones Oportunistas Relacionadas con el SIDA
/
Tuberculosis Resistente a Múltiples Medicamentos
/
Oro
/
Minería
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Africa
Idioma:
En
Revista:
S Afr Med J
Año:
2000
Tipo del documento:
Article