Situation of Multidrug-resistant Tuberculosis - Argentina, 2016-2017

  • Anti-microbial resistance
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Background:
Multidrug-resistant Tuberculosis (MDR-TB) is the tuberculosis (TB) that doesn’t respond to at least isoniazid and rifampicin drugs and it aggravates and complicates the management of all forms of TB. In Argentina, 80 MDR-TB cases were reported in 2015 (0.75% of total cases). The objective of this study was to describe the characteristics of TB-MDR cases notified in Argentina in 2016 and 2017.

Methods:
Descriptive analysis of MDR-TB cases notified in 2016-2017. Patient data was obtained from the “Sistema Nacional de Vigilancia de la Salud” and the Tuberculosis Laboratory of the "Dr. Emilio Coni” INER. Absolute and relative frequencies were calculated. Notification rates were calculated per 100,000 population, using estimated population size from the “Instituto Nacional de Estadísticas y Censos”. Significant difference was evaluated using the chi-square test.

Results:
During the biennium, 223 MDR-TB cases were notified in Argentina (57.6% of total drug resistance and 0.97% of the total cases). The biannual rate was 0.31 cases per 100,000 population. The proportion of MDR-TB was significantly higher among men (56%) than women (44%) (p=0,003). 161 patients (71.9%) were between 20 and 55 years old, 40 (17.8%) were children under 20. 195 cases (87.6%) were found in 3 highly urbanized provinces: Buenos Aires (49.8%)—especially in the Metropolitan Area of Buenos Aires—, Santa Fe (19.3%)—especially in the Rosario department—, and Ciudad Autónoma de Buenos Aires (18.5%). 162 (72.7%) cases were pulmonary, 18 (8.0%) extrapulmonary, and 43 (19.3%) didn’t have information about location. 65 (28%) patients had been previously treated for tuberculosis. There was information about HIV coinfection in 79 patients (35.6%), 41 (52%) were HIV coinfection.

Conclusion:
Reported cases of MDR-TB were concentrated in dense urban areas, where social factors improve its perpetuation. The timely detection and strict monitoring of MDR-TB and study of their characteristics are important, especially in the mentioned urban areas.

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