{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T03:24:17Z","timestamp":1778642657544,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,6,3]],"date-time":"2019-06-03T00:00:00Z","timestamp":1559520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004441","name":"Styrelsen f\u00f6r Internationellt Utvecklingssamarbete","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004441","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2019,7]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>To determine prevalent MDR<\/jats:styled-content>\u2010TB<\/jats:styled-content> genotypes and describe treatment outcome and bacteriology conversion in MDR<\/jats:styled-content>\u2010TB<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>Review of laboratory records of 173 MDR<\/jats:styled-content>\u2010TB<\/jats:styled-content> patients from all over Rwanda who initiated treatment under programmatic management of MDR<\/jats:styled-content>\u2010TB<\/jats:styled-content> (PMDT<\/jats:styled-content>) between 2014 and 2015. Fifty available archived isolates were genotyped by mycobacterial interspersed repetitive units \u2013 variable number of tandem repeats (MIRU<\/jats:styled-content>\u2010VNTR<\/jats:styled-content>) genotyping.<\/jats:p><\/jats:sec>Result<\/jats:title>Of the 170 patients whose outcome was known, 114 (66.3%) were cured and 36 (21%) completed the treatment, giving a successful outcome (cured and completed) of 150 (87.3%) patients. Of 20 MDR<\/jats:styled-content>\u2010TB<\/jats:styled-content> patients with unfavourable treatment outcome, 18 died, one failed and one defaulted\/stopped treatment. Of the 18 patients who died, 11 (61%) were HIV<\/jats:styled-content>\u2010coinfected. The treatment outcome was successful for 93.9% among HIV<\/jats:styled-content> negative and 81.8% among HIV<\/jats:styled-content>\u2010coinfected patients (P<\/jats:italic>\u00a0=\u00a00.02). Sputum smear conversion occurred in 3, 46, 57 and 78 patients before 2, 3, 4 and 6\u00a0months, respectively, with median time of sputum smear and culture conversion at 3\u00a0months. The 44 MDR<\/jats:styled-content>\u2010TB<\/jats:styled-content> isolates with MIRU<\/jats:styled-content>\u2010VNTR<\/jats:styled-content> result, showed high genetic diversity with low clustering rate (9.09%) and Uganda II<\/jats:styled-content> being the most prevalent sub\u2010family lineage detected in 68.2% of isolates. Beijing family was the least common genotype detected (2.3%, 1 isolate).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The high success rates for MDR<\/jats:styled-content>\u2010TB<\/jats:styled-content> treatment achieved in Rwanda were comparable to outcomes observed in resource\u2010rich settings with HIV<\/jats:styled-content> being an independent risk factor for poor treatment outcome. High genetic diversity and low clustering rate reported here suggest that reactivation of previous disease plays an important role in the transmission of MDR<\/jats:styled-content>\u2010TB<\/jats:styled-content> in Rwanda.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13245","type":"journal-article","created":{"date-parts":[[2019,5,8]],"date-time":"2019-05-08T01:48:20Z","timestamp":1557280100000},"page":"879-887","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Highly successful treatment outcome of multidrug\u2010resistant and genetic diversity of multidrug\u2010resistant Mycobacterium tuberculosis<\/i> strains in Rwanda"],"prefix":"10.1111","volume":"24","author":[{"given":"Claude Mambo","family":"Muvunyi","sequence":"first","affiliation":[{"name":"Department of Clinical Biology School of Medicine and Pharmacy University of Rwanda Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Claude Semuto","family":"Ngabonziza","sequence":"additional","affiliation":[{"name":"National Reference Laboratory Division Rwanda Biomedical Centre Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Innocent","family":"Uwimana","sequence":"additional","affiliation":[{"name":"National Reference Laboratory Division Rwanda Biomedical Centre Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean De Dieu","family":"Harelimana","sequence":"additional","affiliation":[{"name":"Department of Biomedical Laboratory Science School of Health Science University of Rwanda Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Mucyo","sequence":"additional","affiliation":[{"name":"Tuberculosis and Other Respiratory Diseases Division Rwanda Biomedical Centre Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osee Rurambya","family":"Sebatunzi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine School of Medicine and Pharmacy University of Rwanda Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry Zawadi","family":"Muvunyi","sequence":"additional","affiliation":[{"name":"Department of Pathology Rwanda Military Hospital Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Seruyange","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine School of Medicine and Pharmacy University of Rwanda Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Masaisa","sequence":"additional","affiliation":[{"name":"Department of Clinical Biology School of Medicine and Pharmacy University of Rwanda Kigali Rwanda"},{"name":"Department of Internal Medicine School of Medicine and Pharmacy University of Rwanda Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Baptiste","family":"Mazarati","sequence":"additional","affiliation":[{"name":"National Reference Laboratory Division Rwanda Biomedical Centre Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Gasana","sequence":"additional","affiliation":[{"name":"Tuberculosis and Other Respiratory Diseases Division Rwanda Biomedical Centre Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,3]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"1","volume-title":"Global Tuberculosis Control: Surveillance, Planning, Financing","author":"World Health Organization","year":"2008"},{"key":"e_1_2_7_3_1","unstructured":"World Health Organization.Global Tuberculosis Report 2017.WHO:Geneva 2017. 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