Non-tuberculous mycobacteria (NTM) in Zambia: prevalence, clinical, radiological and microbiological characteristics

BMC Infectious Diseases

Martin P. Grobusch¹  Peter Mwaba⁶  Veronica Sunkutu⁴  Patrick Katemangwe⁷  Mathias Tembo²  Lutinala Mulenga⁵  Eveline Klinkenberg⁸  Nathan Kapata³  Pascalina Chanda-Kapata¹ 

[1] Center of Tropical Medicine and Travel Medicine, Amsterdam Medical Centre, University of Amsterdam, Amsterdam, Netherlands;Tuberculosis Laboratory, Tropical Diseases Research Centre, Ndola, Zambia;Department of Epidemics and Disease Control, Ministry of Community Development, Mother and Child Health, Lusaka 10101, Zambia;Radiology Department, University Teaching Hospital, Lusaka 10101, Zambia;Department of Clinical Care and Diagnostics, Chest Diseases Laboratory, Ministry of Health, Lusaka 10101, Zambia;Department of Disease Surveillance, Control and Research, Ministry of Health, Lusaka, Zambia;Tuberculosis Laboratory, University Teaching Hospital, Lusaka 10101, Zambia;Department of Global Health and Development, Amsterdam Medical Centre, Amsterdam, Netherlands

关键词: Diagnosis;    Public health;    Emerging;    Non-tuberculous mycobacteria;    Survey;    Epidemiology;   

Others  :  1231022
DOI  :  10.1186/s12879-015-1264-6

 received in 2015-04-01, accepted in 2015-11-05,  发布年份 2015

【 摘 要 】

Background

Non-tuberculous mycobacteria (NTM) infection is an emerging health problem. We present here the Zambia-specific national level data of prevalence, symptomatic, radiological and microbiological characteristics of NTM, using results from a national Tuberculosis (TB) prevalence survey.

Methods

This was a cross-sectional study of the prevalence of NTM among adults aged 15 years and above, who were participants in a national TB prevalence survey. Participants who had either an abnormal chest x-ray or were symptomatic were considered presumptive TB cases and submitted sputum for smear and culture analysis. HIV testing was performed on an opt-out basis. Symptomatic NTM prevalence was estimated from individual level analysis.

Results

Of the 6,123 individuals with presumptive TB, 923 (15.1 %) were found to have NTM, 13 (0.2 %) were MTB/NTM co-infected and 338 (5.5 %) were contaminated (indeterminate). The prevalence of symptomatic NTM was found to be 1,477/100,000 [95 % CI 1010–1943]. Smear positivity, history of cough or chest pain and HIV positivity were risk factors for NTM.

Conclusion

This first study to estimate the national prevalence of NTM in Zambia indicates that the burden is high. The NTM occurrence in Zambia constitutes both a public health and ethical issue requiring action from health managers.

【 授权许可】

   
2015 Chanda-Kapata et al.

【 参考文献 】

• [1]Jamison DT. Disease and Mortality in Sub-Saharan Africa. World Bank Publications, Washington; 2006.
• [2]Field SK, Fisher D, Cowie RL. Mycobacterium avium complex pulmonary disease in patients without HIV infection. Chest. 2004; 126(2):566-81.
• [3]van Ingen J. Diagnosis of nontuberculous mycobacterial infections. Semin Respir Crit Care Med. 2013; 34(1):109.
• [4]Falkinham JO. Epidemiology of infection by nontuberculous mycobacteria. Clin Microbiol Rev. 1996; 9(2):177-215.
• [5]Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F et al.. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007; 175:367-416.
• [6]Johnson MM, Odell JA. Non tuberculous mycobacterial pulmonary infections. J Thorac Dis. 2014; 6(3):210-220.
• [7]Aksamit TR, Philley JV, Griffith DE. Nontuberculous mycobacterial (NTM) lung disease: The top ten essentials. Respir Med. 2013; 108:417-425.
• [8]Satyanarayana G, Heysell KS, Scully KW, Houpt ER. Mycobacterial infections in a large Virginia hospital, 2001–2009. BMC Infect Dis. 2011; 11:113. BioMed Central Full Text
• [9]Matveychuk A, Fuks L, Priess R, Hahim I, Shitrit D. Clinical and radiological features of Mycobacterium kansasii and other NTM infections. Respir Med. 2012; 106:1472-1477.
• [10]dos Santos RP, Scheid KL, Willers DM, Goldani LZ. Comparative radiological features of disseminated disease due to Mycobacterium tuberculosis vs non-tuberculosis mycobacteria among AIDS patients in Brazil. BMC Infect Dis. 2008; 8:24. BioMed Central Full Text
• [11]Taiwo B, Glassroth J. Nontuberculous mycobacterial lung diseases. Infect Dis Clin North Am. 2010; 24(3):769-89.
• [12]Pokam BT and Asuquo AE: Acid-Fast Bacilli Other than Mycobacteria in Tuberculosis Patients Receiving Directly Observed Therapy Short Course in Cross River State, Nigeria. Tuberculosis Research and Treatment 2012, Article ID 301056, 4 pages, 2012. doi:10.1155/2012/301056.
• [13]Cook VJ, Turenne CY, Wolfe J, Pauls R, Kabani A. Conventional methods versus 16S ribosomal DNA sequencing for identification of non-tuberculous mycobacteria: Cost analysis. J Clin Microbiol. 2003; 41(3):1010-1015.
• [14]Zykov MP, Roulet H, Gaya N. Non-tuberculosis mycobacteria in Africa: Isolation and identification. Bull World Health Organ. 1967; 37(6):927-938.
• [15]Aliyu G, El-Kamary S, Abimiku A, Brown C, Tracy K, Hungerford L et al.. Prevalence of Non-Tuberculous Mycobacterial Infections among Tuberculosis Suspects in Nigeria. PLoS One. 2013; 8(5):e63170.
• [16]Crump AJ, Ramadhani HO, Morrissey BA, Saganda W, Mwako MS, Yang L et al.. Invasive disease caused by nontuberculous mycobacteria. Tanzania Emerg Infect Dis. 2009; 15(1):53-5.
• [17]Henkle E, Winthrop KL. Nontuberculous mycobacteria infections in immunosuppressed hosts. Clin Chest Med. 2015; 36(1):91-99.
• [18]Bonard D, Messou E, Seyler C, Vincent V, Gabillard D, Anglaret X. High incidence of atypical mycobacteriosis in African HIV-infected adults with low CD4 cell counts: a 6-year cohort study in Cote d’Ivoire. AIDS. 2004; 18:1961-1964.
• [19]Buijtels PC, van der Sande MA, Parkinson S, Verbrugh HA, Petit P, van Soolingen D. Isolation of non-tuberculous mycobacteria at three rural settings in Zambia; a pilot study. Clin Microbiol Infect. 2010; 16:1142-1148.
• [20]Buijtels PC, van der Sande MA, de Graaff CS, Parkinson S, Verbrugh HA, Petit PLC et al.. Non-tuberculous mycobacteria. Zambia Emerg Infect Dis. 2009; 15(2):242-249.
• [21]World Health Organisation. Tuberculosis Prevalence Surveys: a handbook. WHO/HTM/TB/201.17. WHO, Geneva, Switzerland. Available [Online] from:. http://www. who.int/tb/advisory_bodies/impact_measurement_taskforce/resources_documents/limebook_appendix/en/ webcite
• [22]Floyd S, Sismandis C, Yamada N, Daniel R, Lagahid J, Mecatti F et al.. Analysis of tuberculosis prevalence surveys: new guidance on best-practice methods. Emerging themes in epidemiology. 2013; 10(1):10. BioMed Central Full Text
• [23]Government of The Republic of Zambia. National Tuberculosis Prevalence Survey 2013–2014. Ministry of Health. Lusaka, Zambia. 2015
• [24]Panagiotou M, Papaioannou AI, Kostikas K, Paraskeua M, Velentza E, Maria Kanellopoulou M, Filaditaki V, and Karagiannidis N: The Epidemiology of Pulmonary Nontuberculous Mycobacteria: Data from a General Hospital in Athens, Greece, 2007–2013. Pulmonary Medicine 2014, Article ID 894976, 9 pages. doi:10.1155/2014/894976
• [25]Mirsaeidi M, Machado RF, Garcia JGN, Schraufnagel DE. Nontuberculous mycobacterial disease mortality in the United States, 1999–2010: a population-based comparative study. PLoS One. 2014; 9(3):e91879.
• [26]Sookan L, Coovadia YM. A laboratory-based study to identify and speciate non-tuberculous mycobacteria isolated from specimens submitted to a central tuberculosis laboratory from throughout KwaZulu-Natal Province. South Africa South African Medical Journal. 2014; 104(11):766-768.
• [27]Gunaydin M, Keramettin Y, Eroglu C, Sanic A, Ceyhan I, Erturan Z et al.. Distribution of nontuberculous mycobacteria strains. Ann Clin Microbiol Antimicrob. 2013; 12:33. BioMed Central Full Text
• [28]Kendall BA, Varley CD, Hedberg K, Cassidy PM, Winthrop KL. Isolation of non-tuberculous mycobacteria from the sputum of patients with active tuberculosis. Int J Tuberc Lung Dis. 2010; 14(5):654-6.
• [29]Marras TK, Chedore P, Ying AM, Jamieson F. Isolation prevalence of pulmonary non-tuberculous mycobacteria in Ontario, 1997 2003. Thorax. 2007; 62(8):661-6.