Extensively drug-resistant tuberculosis in Togo: first reported cases and implications for tuberculosis control

TL;DR

This paper reports the first cases of extensively drug-resistant tuberculosis in Togo, highlighting challenges in diagnosis and treatment.

Contribution

The study presents the first documented cases of XDR-TB in Togo and discusses implications for TB control in resource-limited settings.

Findings

XDR-TB cases in Togo demonstrate the growing threat of drug-resistant tuberculosis in low-resource regions.

Diagnosis delays and treatment complexity underscore the need for improved diagnostic tools and strategies.

Successful treatment outcomes were observed with tailored regimens and early diagnosis.

Abstract

•The increase in cases of extensively drug-resistant tuberculosis in resource-limited countries is undermining World Health Organization efforts.•A series of three cases, including two patients not infected with HIV.•The varying length of time taken to diagnose cases in resource-limited countries.•The complexity of treatment and the toxicity of aminoglycosides.

The increase in cases of extensively drug-resistant tuberculosis in resource-limited countries is undermining World Health Organization efforts.

A series of three cases, including two patients not infected with HIV.

The varying length of time taken to diagnose cases in resource-limited countries.

The complexity of treatment and the toxicity of aminoglycosides.

The increasing burden of extensively drug-resistant tuberculosis (XDR-TB) undermines global TB control efforts.

This was a case series study conducted from January 1, 2007, to December 31, 2024, in the Department of Pulmonology at Sylvanus Olympio University Teaching Hospital.

We report a series of three cases. Case 1: A 30-year-old man with a history of contact with an XDR-TB case was treated with a 20-month regimen. Culture conversion was achieved at the 3rd month of treatment. A complication in the form of pyopneumothorax occurred during the 6th month of therapy. Case 2: A 51-year-old patient with no significant medical history was diagnosed with XDR-TB after 4 months of treatment for multidrug-resistant TB (MDR-TB). Conversion of follow-up cultures was achieved 2 months after modification of the treatment regimen. Case 3: A 62-year-old woman living with human immunodeficiency virus (HIV), previously treated for MDR-TB, developed XDR-TB during the course of treatment. The patient died on the 29th day of XDR-TB treatment.

XDR-TB is a curable disease. Early and accurate diagnosis allows for better selection of the most appropriate treatment strategy.

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