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Diarra B, Decroo T, Somboro A, Coulibaly G, Tolofoudie M, Kone M, Degoga B, Diallo F, Togo ACG, Sanogo M, Sarro YS, Cisse AB, Kodio O, Baya B, Kone A, Maiga M, Dao S, Maiga II, Murphy RL, Siddiqui S, Toloba Y, Konate B, Diakite M, Doumbia S, Van Deun A, Rigouts L, Diallo S, de Jong BC. Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali. Int J Tuberc Lung Dis 2021; 24:763-769. [PMID: 32912379 DOI: 10.5588/ijtld.19.0698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RR-TB.METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RR-TB.RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7-3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDA-negative at 2M (P = 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%.CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.
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Affiliation(s)
- B Diarra
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali, Unit of Mycobacteriology, Institute of Tropical Medicine Antwerp, Antwerp
| | - T Decroo
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Antwerp, Research Foundation Flanders, Brussels, Belgium
| | - A Somboro
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - G Coulibaly
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Tolofoudie
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Kone
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B Degoga
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - F Diallo
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A C G Togo
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Sanogo
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Y S Sarro
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A B Cisse
- Laboratoire National de Référence des Mycobactéries, Institut National de Recherche en Santé publique, Bamako, Mali
| | - O Kodio
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B Baya
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A Kone
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Maiga
- Global Health, Northwestern University, Chicago, IL, USA
| | - S Dao
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - I I Maiga
- Laboratoire d´analyses Médicales et Hygiène Hospitalière du Centre Hospitalier Universitaire du Point-G, Bamako, Mali
| | - R L Murphy
- Laboratoire National de Référence des Mycobactéries, Institut National de Recherche en Santé publique, Bamako, Mali
| | - S Siddiqui
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Y Toloba
- Service de Pneumo-phtisiologie du Centre Hospitalier Universitaire du Point-G, Bamako
| | - B Konate
- Programme National de Lutte contre la Tuberculose (PNLT), Ministère de la santé et des Affaires Sociales, Bamako, Mali
| | - M Diakite
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - S Doumbia
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - L Rigouts
- Unit of Mycobacteriology, Institute of Tropical Medicine Antwerp, Antwerp, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - S Diallo
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B C de Jong
- Unit of Mycobacteriology, Institute of Tropical Medicine Antwerp, Antwerp
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Diarra B, Tolofoudie M, Sarro YS, Togo ACG, Bane S, Nientao I, Cisse AB, Kone M, Somboro A, Degoga B, Diallo F, Coulibaly G, Kodio O, Sanogo M, Kone B, Diabate S, Baya B, Kone A, Dabitao D, Maiga M, Belson M, Dao S, Maiga II, Murphy RL, Siddiqui S, Toloba Y, Konate B, Doumbia S, de Jong BC, Diallo S. Diabetes Mellitus among new tuberculosis patients in Bamako, Mali. J Clin Tuberc Other Mycobact Dis 2019; 17:100128. [PMID: 31788570 PMCID: PMC6879999 DOI: 10.1016/j.jctube.2019.100128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Diabetes Mellitus (DM) increases worldwide, mostly in low- and middle-income countries. In Mali, the prevalence in the adult population is estimated at 1.8%, but tuberculosis (TB) patients are not systematically screened. The goal of our study was to determine the prevalence of DM among newly diagnosed TB patients. Methods We conducted a cross sectional study and a pilot prospective cohort study in four health centers in Bamako. All patients underwent fasting capillary-blood glucose (FCBG) test at Day 0, and repeated after one-week of TB treatment. Venous FBG test was performed for discrepancies between the two FCBG results. Thereafter, FCBG was performed for pilot study at month-2 (M2) and M5 of TB treatment. Results Two hundred and one patients were enrolled in this study. Impaired fasting blood glucose was identified in 17 (8.5%), of whom 11 (5.5%) had DM (VFBG >7 mmol/L). Among patients with DM, seven (63.6%) had successful TB treatment outcome, versus 142 (74.7%) of those without DM (p = 0.64), and (OR: 1.69, 95%CI 0.47–6.02). Conclusion The prevalence of DM among TB patients in Bamako exceeds that of the general population and screening at TB diagnosis suffices to identify those with DM. Systematic screening of both diseases will allow better treatment.
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Affiliation(s)
- B Diarra
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.,Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - M Tolofoudie
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y S Sarro
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A C G Togo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Bane
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - I Nientao
- Service de Médecine et d'Endocrinologie de l'hôpital du Mali, Bamako, Mali
| | - A B Cisse
- Laboratoire National de Référence des Mycobactéries (LNR), Institut National de Recherche en Santé publique (INRSP), Bamako, Mali
| | - M Kone
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Somboro
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Degoga
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - F Diallo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - G Coulibaly
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - O Kodio
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M Sanogo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Kone
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Diabate
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Baya
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Kone
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - D Dabitao
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M Maiga
- Global Health, Northwestern University, Chicago, IL, United States
| | - M Belson
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States
| | - S Dao
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - I I Maiga
- Laboratoire d'analyses Médicales et Hygiène Hospitalière du Centre Hospitalier Universitaire du Point-G, Bamako, Mali
| | - R L Murphy
- Global Health, Northwestern University, Chicago, IL, United States
| | - S Siddiqui
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States
| | - Y Toloba
- Service de Pneumo-phtisiologie du Centre Hospitalier Universitaire du Point-G, Bamako, Mali
| | - B Konate
- Programme National de Lutte contre la Tuberculose (PNLT), Ministère de la santé et de l'hygiène publique, Bamako, Mali
| | - S Doumbia
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B C de Jong
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - S Diallo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
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