Genexpert data for Rifampicin resistance in Swaziland - a retrospective analysis from 2012-2016

Abstract

Surveillance of anti-TB drug resistance is key for sustained TB control. GeneXpert may provide a new avenue at least for Rifampicin resistance surveillance. This study used GeneXpert data to determine epidemiological prevalence of rifampicin resistance in Swaziland from 2012–2016. Nine laboratories in Swaziland were purposively selected and from them 50% of GeneXpert records were included in the study. Data was analysed using SAS studio version 9.04. Of the 5418 GeneXpert records included, 50.8% were from males. The prevalence of rifampicin resistance was 10.5%, 10.8%, 11.3, 11,3 and 11,8 for 2012, 2013, 2014, 2015 and 2016 respectively. Further, probe E was the most common locus of mutation conferring rifampicin resistance accounting for 62.2% of all resistance. This study showed that routine data from GeneXpert can be used for epidemiological surveillance of rifampicin resistance and can be used to develop a simple continuous system of rifampicin resistance surveillance.

Cherechedzo yehukukutu hwemabhakitiriya anokonzera rurindi, kumishonga kunobatsira kurwisa kwechirwere cherurindi. Kubva pasichigare, ruzivo rwemamiriro ehukukutu hwemabhakitiriya anokonzera rurindi rwaiwanikwa kubva kuwongororo yekukudza mabhakitiriya muchikafu chinemishonga. Inodaidzwa kuti culture and DST muchirungu. Saka, tsvagurudzo ino iri maererana nekutsvaga huwandu hwehukukutu hwerurindi kumushonga werifampicin munyika yeSwaziland semawanikirwe azvakaitwa neGeneXpert mumakore anoti 2012 kusvikira 2016. Pakutanga zvipatara zvipfumbamwe zvakasarudzwa mavune kuti varwere vachapinda musarudzo vange vachibva kwazviri. Mudanho repiri chikamu chimwe muzviviri zvevarwere vese vakanga vabatwa rurindi neGeneXpert mumakore 2012–2016 vakasarudzwa kuti vapinde mutsvagurudzo. Ruzivo pamusoro pevakasarudzwa rwakaunganizdwa, nokukwenzverwa ruchibva rwaongororwa neSAS version 9.04 Varwere 5418 ndivo vakapinda muongororo zvikawanikwa kuti chikamu chinoit 50.8 kubva muzana vakanga vari vechirume. Zvakare mumakore anoti 2012 zvichienda kuna 2016 varwere vakanga vaine rurindi rwune hukukutu kumushonga werifampicin vaiva zvikamu zvinoti 10.5%, 10.8%, 11.3, 11,3 ne 11,8 kubva muzana zvichiendera nemakore. Uyezve, rupandi rwechishanu (probe E), ndirwo rwakanga ruri rwakajairika senzvimbo inobva hukukutu hwerurindi kumushonga werifampicin. Probe E yaisanganisira zvikamu 62.2 kubva muzana zvenzvimbo dzese dzaibva hukukutu. Yaiteverwa ne Probe D, B, C na A idzo dzaisanganisira zvikamu 25.3, 8.6, 2.5 ne 1.3 kubva muzana zvichienda zvakadaro. Tsvakurudzo ino yakaratidza pachena kuti GeneXpert inogona kushandiswa kuunganidza ruzivo rwehukukutu hwerurindi kumushonga werifampicin. Uyezve GeneXpert inogona kutaridza mafambire anoita hukukutu hwerurindi kumushonga werifampicin nekufamba kwenguva, zvikamu zvevanhu nekwavanogara. Saka munyika dzisina kunyanyobudirira, ruzivo runobva kuGeneXpert runogona kushandiswa zviri nyore kugadzira cherechedzo yehukukutu hwerifampicin.

Lucwaningo lwekuhlola kugwama kweligciwane lesifuba sengati (TB) kumitsi lubalulekile kulamwula sifo sesifuba sengati eveni. Lolucwaningo lutoveta bukhulu benkinga leyentiwa ngulokugwama nekuveta imiphumela yetindlela letikhona tekulapha nekufundzisa ngalo leligciwane. Indlela lebeyivamile yekupopola kugwama kweligciwane bekungu Phenotypic DST, kodwa bakaMhlaba Betemphilo sebapasise tindlendlela letinsha (Molecular methods) letifaka ekhatsi iGeneXpert. Lolucwaningo luveta sisindo sekugwama kwaleli gciwane emutsini we iRifambicin ngekuhlola kweGeneXpert Eswatini kusukela ngemnyaka wa2012 kuya ku2016. Lolucwaningo lwaba tigaba letimbili tekukhetsa tindzawo tekulwenta. Sigaba sekucala safaka emaLaboratory lasishiya galolunye (9) kuletifundza letine telive. Sigaba sesibili saba ngalokunge mashumi lasihlanu ekhulwini (50%) wawo wonke imphumela yeGeneXpert. Letinombolo letatfolakala lapho tahlungwa ngeSAS Studio 9.04. Tinkhulungwane letisihlanu emakhulu lamane lanelishumi nesiphohlongo (5418) bangelela lolucwaningo, kubo labangemashumi lasihlanu nencenye bebadvuna. Imphumela yekugwama kwemutsi weRifambicin beyime kanje 10.5%, 10.8%, 11,3% 11.3%, na11.8% ngeminyaka lelandzelana kanje 2012, 2013, 2014, 2015 na2016. Phinze kwavela kutsi Probe E nguye abenetibalo letisettulu kuRifambicin ngalokungemashumi lasitfupha ekhulwini nencenye (62.2%). Kululokunye kwabonakala kutsi Proe D, B, C naA ngekulandzelana baba ngu 25.3%, 8.6%, 2.5% na1.3% alokugwama kweligciwane. Lolucwaningo lwakhomba kutsi tinombolo tekupopola ngeGeneXpert tingakhomba kutsi babani labanenkinga lenkulu yekugwama phindze tikhombe kutsi bebabangaki futsi babulili buni bebanaleligwamile ngetikhatsi letehlukene netindzawo. Lolucwaningo luvete kutsi emave lanemnotfo nontengantengako angasebentisa lucwaningo loluchubekako lolukhomba linani lekugwama kuRifambicin kwaleligciwane kusetjentiswa tinombolo tekupopola teGeneXpert.