Current Organisation

Current Job Title

Biography

Project Title

Master in Field Epidemiology Training for Portuguese-speaking West African Countries (FETP-CV)

EDCTP Project Call

Disease Outbreak and Epidemic Response (EPI Fellows)

Host Organisation

Project Objectives

1. To characterize the sociodemographic, clinical, and epidemiological profile of all patients included in the study 2. To estimate the prevalence of TBMR 3. To identify the clinical, sociodemographic, and epidemiological factors associated with the occurrence of TBMR

Study Design

Analytical cross-sectional observational study

Project Summary

Tuberculosis (TB) remains a significant public health concern, particularly in low-income countries. The emergence of drug-resistant strains has further exacerbated the situation. In Guinea-Bissau, the growing number of multidrug-resistant TB cases is a cause for concern given the limited resources available. Building on the findings of the study 'From Latent Infection to Active Tuberculosis', this study sought to estimate the prevalence of MDR-TB and pinpoint the associated risk factors at Raoul Follereau Hospital in Bissau, Guinea-Bissau. A cross-sectional study was conducted at Raoul Follereau Hospital, Bissau, between 2022 and 2023. Cases of tuberculosis and multidrug-resistant tuberculosis for which complete sociodemographic and clinical-epidemiological data were available were included. Descriptive and inferential statistical analyses were performed, including univariate and multivariate logistic regression, to identify risk factors associated with MDR-TB. Crude and adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were calculated. Of the 228 TB patients, 36 (15.8%) were confirmed as having MDR-TB using the GeneXpert test. The participants' ages ranged from 15 to 84 years, and the majority were male (170; 74.6%), predominantly in the 25–34 age group (77; 33.8%). Notably, 196 participants (86%) had no prior history of TB treatment. The most common outcome was cure (146; 64.0%), while 77 patients (33.8%) were lost to follow-up. The prevalence of MDR-TB was 18.75% (6/32) among previously treated cases and 15.31% (30/196) among newly diagnosed patients. Significant predictors of MDR-TB were male sex (adjusted odds ratio (aOR)=3.75; 95% confidence interval (CI): 1.12–12.57; p=0.03) and divorced marital status (aOR=7.66; 95% CI: 1.06–54.93; p=0.04). This study highlights an overall MDR-TB prevalence of 15.8% (95% CI: 11.6–21.2%), with a significantly higher risk among men and divorced individuals. The substantial number of cases among untreated patients suggests that community transmission of resistant strains plays a crucial role. To mitigate this growing public health threat, it is essential to expand early diagnostic capacity and prioritise vulnerable groups.