# 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.

## Key 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.