- Anti-tuberculosis drug resistance in Sub-Saharan Africa: The case of Uganda
- Award date
- 12 February 2015
- Number of pages
- Document type
- PhD thesis
- Faculty of Medicine (AMC-UvA)
This thesis reports findings of six studies including two tuberculosis (TB) drug resistance surveys, a comparative study of HIV infection rates among patients enrolled in the survey and those under routine TB/HIV surveillance, two TB molecular epidemiological analyses and a systematic review and meta-analysis of drug-resistant TB in sub-Saharan Africa.
It provides a general introduction to anti-tuberculosis drug resistance in the world and associated risk factors. Results from the drug resistance surveys presented show low levels of anti-TB drug resistance (DR) rates considering WHO estimates. Findings from these studies also indicated that anti-TB DR and HIV infection are not associated. From these studies we show consistently lower levels of TB/HIV co-infection among survey participants compared to what is reported under routine TB/HIV surveillance by the National TB/Leprosy Program.
Through the molecular epidemiological studies, we confirm and document the predominant MTC lineages in Uganda and the negative association of the predominant lineage with TB DR.
We explored anti-TB DR rates in relation to HIV infection elsewhere in sub-Saharan Africa through a systematic review. This analysis showed that pooled estimates of anti-TB DR including MDR-TB in this region are almost half of the global WHO estimates and that MDR-TB is not associated with HIV, despite TB/HIV co-infection rates being highest in this region.
Finally, we discuss findings of the studies in general and policy implications to technically recommend to the national TB programs feasible interventions for prevention and control of DR-TB in this region.
- Research conducted at: national Tuberculosis and Leprosy Program Kampala Uganda
If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library, or send a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible.