An Overview of the Management of Drug-Resistant Tuberculosis in Six French-Speaking African Countries from 2018 to 2022

TL;DR

This paper examines the management of drug-resistant tuberculosis in six French-speaking African countries from 2018 to 2022, highlighting progress and remaining challenges.

Contribution

The study provides an empirical analysis of MDR-TB management and outcomes in six African countries over a five-year period.

Findings

Only 86.4% of reported MDR-TB cases received treatment, with significant gaps in case detection.

MDR-TB treatment success rates varied widely between countries, ranging from 44.4% to 90.9%.

Only 52 XDR-TB cases were treated over five years, indicating limited capacity for managing the most severe forms of TB.

Abstract

Drug-resistant tuberculosis (DR-TB) poses a significant public health challenge, particularly in resource-limited settings. The prevalence and management of DR-TB in African countries require comprehensive strategies to improve patient outcomes and control the spread of the disease. Aggregated routine data (from 2018 to 2022) on multidrug-resistant TB (MDR-TB) were collected from the National TB Programs (NTPs) from all six countries. The diagnostic capacity for MDR-TB was globally insufficient. The system for collecting and transporting samples was sometimes inoperative. A total of 2353 cases of MDR-TB were reported, with 86.4% receiving treatment. The gap between the expected number of MDR-TB cases and the number reported per country varied from 51.5% to 88.0%, depending on the year. Fifty-two extensively drug-resistant (XDR) TB cases received treatment regimens over five years, with variations across countries. All patients received free follow-up examinations, nutritional and financial support for travel expenses to the outpatient care and treatment centers. The MDR-TB treatment success rates for all regimens between 2018 and 2021 ranged from 44.4 to 90.9%, varying by country and year. The information system relied on primary tools, reporting tools, and digital solutions. Progress has been made in MDR-TB management; however, challenges persist, necessitating resources to enhance access to rapid molecular screening tests.