{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:57:09Z","timestamp":1787021829688,"version":"build-2736575974"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>\n                    Multi-drug-resistant and rifampicin-resistant tuberculosis (MDR\/RR-TB) pose an urgent health threat in Ghana. Despite ongoing interventions, the outcomes for MDR\/RR-TB in Ghana have remained suboptimal over recent years. During this period, there has been an increasing detection of nontuberculous mycobacteria (NTM) in mycobacterial cultures. We sought to examine if the isolation of NTM could be a factor contributing to unfavourable MDR\/RR-TB treatment outcomes. We also estimated predictors of NTM isolation, including using the short-course injectable-containing regimen (SCI) versus the all-oral bedaquiline (SCO) regimen and other covariates. This retrospective cohort study analysed MDR\/RR-TB patients in Ghana from 2018 to 2021 across four regions. Demographic, clinical, and diagnostic data were collected under the National Tuberculosis Control Program framework. Mycobacterial smears and cultures were used to monitor treatment response, with further identification of NTM using line probe assays and Sanger sequencing. Multivariable logistic regression models evaluated predictors of NTM isolation and having an unfavourable outcome. Of 427 identified MDR\/RR-TB patients, 380 were included for analysis: 76.3% were male, the mean age was 43.9 years, and 18.9% were people living with HIV. NTM were isolated in 7.1% of cases, primarily\n                    <jats:italic>Mycobacterium intracellulare<\/jats:italic>\n                    and\n                    <jats:italic>M. fortuitum<\/jats:italic>\n                    , with higher odds of isolation in individuals from the Eastern Region (aOR:14.18, 95% CI: 3.95-50.92). Overall, 67.9% achieved favourable outcomes: 71.4% (185\/259) in those on the SCO versus 60.3% (73\/121) on the SCI regimen. People living with HIV (aOR 14.18, 95% CI: 3.95-50.92) had an increased odds of having an unfavourable outcome. NTM isolation was not associated with unfavourable outcomes. Our study results suggest that although NTM isolation may occur during the course of MDR\/RR-TB treatment, it does not affect MDR\/RR-TB treatment outcome. Future research should further explore the implications of NTM co-infection on longer-term MDR\/RR-TB outcomes, such as post-TB lung disease, to refine management strategies tailored to the reality of low-resource, high-burden settings.\n                  <\/jats:p>","DOI":"10.1371\/journal.pntd.0013204","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T13:45:38Z","timestamp":1751463938000},"page":"e0013204","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Treatment outcomes of multi-drug-resistant and rifampicin-resistant tuberculosis with and without isolation of nontuberculous mycobacteria between 2018\u20132021: A retrospective cohort study in Ghana"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3296-1266","authenticated-orcid":true,"given":"Elizabeth Tabitha","family":"Abbew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Laryea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ama Owusuaa","family":"Kwakye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaw Adusi","family":"Poku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorcas","family":"Obiri-Yeboah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutgarde","family":"Lynen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Decroo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leen","family":"Rigouts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Lorent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"pntd.0013204.ref001","volume-title":"2024 Global tuberculosis report","author":"World Health Organisation","year":"2024"},{"key":"pntd.0013204.ref002","volume-title":"Global tuberculosis report 2016","author":"World Health Organisation","year":"2016"},{"issue":"9","key":"pntd.0013204.ref003","article-title":"Trends in prevalence of multi drug resistant tuberculosis in sub-Saharan Africa: a systematic review and meta-analysis","volume":"12","author":"BM Musa","year":"2017","journal-title":"PLoS One"},{"key":"pntd.0013204.ref004","doi-asserted-by":"crossref","first-page":"4707","DOI":"10.2147\/IDR.S377238","article-title":"Treatment outcome of MDR\/RR TB in a resource-constrained setup: a four-year retrospective analysis","volume":"15","author":"AA Omer","year":"2022","journal-title":"Infect Drug Resist"},{"issue":"20","key":"pntd.0013204.ref005","doi-asserted-by":"crossref","first-page":"10678","DOI":"10.3390\/ijerph182010678","article-title":"Tuberculosis treatment outcome and predictors in Africa: a systematic review and meta-analysis","volume":"18","author":"MY Teferi","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"pntd.0013204.ref006","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000615","article-title":"Non-tuberculous mycobacteria in TB-endemic countries: are we neglecting the danger?","volume":"4","author":"K Gopinath","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013204.ref007","doi-asserted-by":"crossref","first-page":"303","DOI":"10.3389\/fimmu.2020.00303","article-title":"The rise of non-tuberculosis mycobacterial lung disease","volume":"11","author":"CN Ratnatunga","year":"2020","journal-title":"Front Immunol"},{"issue":"10","key":"pntd.0013204.ref008","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.arbr.2017.08.004","article-title":"Non-tuberculous mycobacteria. 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