Antituberculosis Drug Resistance Survey in Lesotho, 2008-2009: Lessons LearnedReport as inadecuate

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Drug resistance is an increasing threat to tuberculosis TB control worldwide. The World Health Organization advises monitoring for drug resistance, with either ongoing surveillance or periodic surveys.


The antituberculosis drug resistance survey was conducted in Lesotho in 2008-2009. Basic demographic and TB history information was collected from individuals with positive sputum smear results at 17 diagnostic facilities. Additional sputum sample was sent to the national TB reference laboratory for culture and drug susceptibility testing.


Among 3441 eligible smear-positive persons, 1121 32.6% were not requested to submit sputum for culture. Among 2320 persons submitted sputum, 1164 50.2% were not asked for clinical information or did not have valid sputum samples for testing. In addition, 445-2320 19.2% were excluded from analysis because of other laboratory or data management reasons. Among 984-3441 28.6% persons who had data available for analysis, MDR-TB was present in 24-773 3.1% of new and 25-195 12.8% of retreatment TB cases. Logistical, operational and data management challenges affected survey results.


MDR-TB is prevalent in Lesotho, but limitations reduced the reliability of our findings. Multiple lessons learned during this survey can be applied to improve the next drug resistance survey in Lesotho and other resource constrained countries may learn how to avoid these bottlenecks.

Author: Llang B. Maama-Maime , Mathabo Mareka , Julia V. Ershova , Thabong E. Tlali , Kekeletso Kao , Mamakhetha Phalatse , Lauren Polans



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