The emerging threat of pre-extensively drug-resistant tuberculosis in West Africa: preparing for large-scale tuberculosis research and drug resistance surveillance
Identifieur interne : 000101 ( Pmc/Curation ); précédent : 000100; suivant : 000102The emerging threat of pre-extensively drug-resistant tuberculosis in West Africa: preparing for large-scale tuberculosis research and drug resistance surveillance
Auteurs : Florian Gehre [Gambie, Belgique] ; Jacob Otu [Gambie] ; Lindsay Kendall [Gambie] ; Audrey Forson [Ghana] ; Awewura Kwara [États-Unis] ; Samuel Kudzawu [Ghana] ; Aderemi O. Kehinde [Nigeria] ; Oludele Adebiyi ; Kayode Salako ; Ignatius Baldeh [Gambie] ; Aisha Jallow [Gambie] ; Mamadou Jallow [Gambie] ; Anoumou Dagnra [Togo] ; Kodjo Dissé [Togo] ; Essosimna A. Kadanga [Togo] ; Emmanuel Oni Idigbe [Nigeria] ; Catherine Onubogu [Nigeria] ; Nneka Onyejepu [Nigeria] ; Aissatou Gaye-Diallo [Sénégal] ; Awa Ba-Diallo [Sénégal] ; Paulo Rabna [Guinée-Bissau] ; Morto Mane [Guinée-Bissau] ; Moumine Sanogo [Mali] ; Bassirou Diarra [Mali] ; Zingue Dezemon [Burkina Faso] ; Adama Sanou [Burkina Faso] ; Madikay Senghore [Gambie, Royaume-Uni] ; Brenda A. Kwambana-Adams [Gambie, Royaume-Uni] ; Edward Demba [Gambie] ; Tutty Faal-Jawara [Gambie] ; Samrat Kumar [Belgique] ; Leopold D. Tientcheu [Gambie, Cameroun] ; Adama Jallow [Gambie] ; Samba Ceesay [Gambie] ; Ifedayo Adetifa [Royaume-Uni, Gambie] ; Assan Jaye [Gambie] ; Mark J. Pallen [Royaume-Uni] ; Umberto D Lessandro [Royaume-Uni, Gambie, Belgique] ; Beate Kampmann [Gambie, Royaume-Uni] ; Richard A. Adegbola [Belgique] ; Souleymane Mboup [Sénégal] ; Tumani Corrah [Gambie] ; Bouke C. De Jong [Belgique] ; Martin Antonio [Gambie, Royaume-Uni]Source :
- BMC Medicine [ 1741-7015 ] ; 2016.
Abstract
Drug-resistant tuberculosis (TB) is a global public health problem. Adequate management requires baseline drug-resistance prevalence data. In West Africa, due to a poor laboratory infrastructure and inadequate capacity, such data are scarce. Therefore, the true extent of drug-resistant TB was hitherto undetermined. In 2008, a new research network, the West African Network of Excellence for Tuberculosis, AIDS and Malaria (WANETAM), was founded, comprising nine study sites from eight West African countries (Burkina Faso, The Gambia, Ghana, Guinea-Bissau, Mali, Nigeria, Senegal and Togo). The goal was to establish Good Clinical Laboratory Practice (GCLP) principles and build capacity in standardised smear microscopy and mycobacterial culture across partnering laboratories to generate the first comprehensive West African drug-resistance data.
Following GCLP and laboratory training sessions, TB isolates were collected at sentinel referral sites between 2009–2013 and tested for first- and second-line drug resistance.
From the analysis of 974 isolates, an unexpectedly high prevalence of multi-drug-resistant (MDR) strains was found in new (6 %) and retreatment patients (35 %) across all sentinel sites, with the highest prevalence amongst retreatment patients in Bamako, Mali (59 %) and the two Nigerian sites in Ibadan and Lagos (39 % and 66 %). In Lagos, MDR is already spreading actively amongst 32 % of new patients. Pre-extensively drug-resistant (pre-XDR) isolates are present in all sites, with Ghana showing the highest proportion (35 % of MDR). In Ghana and Togo, pre-XDR isolates are circulating amongst new patients.
West African drug-resistance prevalence poses a previously underestimated, yet serious public health threat, and our estimates obtained differ significantly from previous World Health Organisation (WHO) estimates. Therefore, our data are reshaping current concepts and are essential in informing WHO and public health strategists to implement urgently needed surveillance and control interventions in West Africa.
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DOI: 10.1186/s12916-016-0704-5
PubMed: 27806714
PubMed Central: 5094099
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Aderemi O. Kehinde<affiliation><nlm:aff id="Aff7">University College Hospital, Ibadan, Oyo 23402 Nigeria</nlm:aff><wicri:noCountry code="subfield">Oyo 23402 Nigeria</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff7">University College Hospital, Ibadan, Oyo 23402 Nigeria</nlm:aff><wicri:noCountry code="subfield">Oyo 23402 Nigeria</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff7">University College Hospital, Ibadan, Oyo 23402 Nigeria</nlm:aff><wicri:noCountry code="subfield">Oyo 23402 Nigeria</wicri:noCountry></affiliation>Le document en format XML
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xml:lang="fr">Nigeria</country><wicri:regionArea>Nigerian Institute of Medical Research, Lagos</wicri:regionArea></affiliation></author><author><name sortKey="Onyejepu, Nneka" sort="Onyejepu, Nneka" uniqKey="Onyejepu N" first="Nneka" last="Onyejepu">Nneka Onyejepu</name><affiliation wicri:level="1"><nlm:aff id="Aff10">Nigerian Institute of Medical Research, Lagos, Nigeria</nlm:aff><country xml:lang="fr">Nigeria</country><wicri:regionArea>Nigerian Institute of Medical Research, Lagos</wicri:regionArea></affiliation></author><author><name sortKey="Gaye Diallo, Aissatou" sort="Gaye Diallo, Aissatou" uniqKey="Gaye Diallo A" first="Aissatou" last="Gaye-Diallo">Aissatou Gaye-Diallo</name><affiliation wicri:level="1"><nlm:aff id="Aff11">Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar, Senegal</nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar</wicri:regionArea></affiliation></author><author><name sortKey="Ba Diallo, Awa" sort="Ba Diallo, Awa" uniqKey="Ba Diallo A" first="Awa" last="Ba-Diallo">Awa Ba-Diallo</name><affiliation wicri:level="1"><nlm:aff id="Aff11">Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar, Senegal</nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar</wicri:regionArea></affiliation></author><author><name sortKey="Rabna, Paulo" sort="Rabna, Paulo" uniqKey="Rabna P" first="Paulo" last="Rabna">Paulo Rabna</name><affiliation wicri:level="1"><nlm:aff id="Aff12">National Institute of Public Health, Bissau, Guinea-Bissau</nlm:aff><country xml:lang="fr">Guinée-Bissau</country><wicri:regionArea>National Institute of Public Health, Bissau</wicri:regionArea></affiliation></author><author><name sortKey="Mane, Morto" sort="Mane, Morto" uniqKey="Mane M" first="Morto" last="Mane">Morto Mane</name><affiliation wicri:level="1"><nlm:aff id="Aff12">National Institute of Public Health, Bissau, Guinea-Bissau</nlm:aff><country xml:lang="fr">Guinée-Bissau</country><wicri:regionArea>National Institute of Public Health, Bissau</wicri:regionArea></affiliation></author><author><name sortKey="Sanogo, Moumine" sort="Sanogo, Moumine" uniqKey="Sanogo M" first="Moumine" last="Sanogo">Moumine Sanogo</name><affiliation wicri:level="1"><nlm:aff id="Aff13">SEREFO Program, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali</nlm:aff><country xml:lang="fr">Mali</country><wicri:regionArea>SEREFO Program, University of Sciences, Techniques and Technologies of Bamako, Bamako</wicri:regionArea></affiliation></author><author><name sortKey="Diarra, Bassirou" sort="Diarra, Bassirou" uniqKey="Diarra B" first="Bassirou" last="Diarra">Bassirou Diarra</name><affiliation wicri:level="1"><nlm:aff id="Aff13">SEREFO Program, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali</nlm:aff><country xml:lang="fr">Mali</country><wicri:regionArea>SEREFO Program, University of Sciences, Techniques and Technologies of Bamako, Bamako</wicri:regionArea></affiliation></author><author><name sortKey="Dezemon, Zingue" sort="Dezemon, Zingue" uniqKey="Dezemon Z" first="Zingue" last="Dezemon">Zingue Dezemon</name><affiliation wicri:level="1"><nlm:aff id="Aff14">Centre Muraz and the National TB Program, Ouagadougou, Burkina Faso</nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre Muraz and the National TB Program, Ouagadougou</wicri:regionArea></affiliation></author><author><name sortKey="Sanou, Adama" sort="Sanou, Adama" uniqKey="Sanou A" first="Adama" last="Sanou">Adama Sanou</name><affiliation wicri:level="1"><nlm:aff id="Aff14">Centre Muraz and the National TB Program, Ouagadougou, Burkina Faso</nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre Muraz and the National TB Program, Ouagadougou</wicri:regionArea></affiliation></author><author><name sortKey="Senghore, Madikay" sort="Senghore, Madikay" uniqKey="Senghore M" first="Madikay" last="Senghore">Madikay Senghore</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff15">Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry</wicri:regionArea></affiliation></author><author><name sortKey="Kwambana Adams, Brenda A" sort="Kwambana Adams, Brenda A" uniqKey="Kwambana Adams B" first="Brenda A." last="Kwambana-Adams">Brenda A. Kwambana-Adams</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff16">Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation></author><author><name sortKey="Demba, Edward" sort="Demba, Edward" uniqKey="Demba E" first="Edward" last="Demba">Edward Demba</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Faal Jawara, Tutty" sort="Faal Jawara, Tutty" uniqKey="Faal Jawara T" first="Tutty" last="Faal-Jawara">Tutty Faal-Jawara</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Kumar, Samrat" sort="Kumar, Samrat" uniqKey="Kumar S" first="Samrat" last="Kumar">Samrat Kumar</name><affiliation wicri:level="1"><nlm:aff id="Aff19">Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Tientcheu, Leopold D" sort="Tientcheu, Leopold D" uniqKey="Tientcheu L" first="Leopold D." last="Tientcheu">Leopold D. Tientcheu</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff22">Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Jallow, Adama" sort="Jallow, Adama" uniqKey="Jallow A" first="Adama" last="Jallow">Adama Jallow</name><affiliation wicri:level="1"><nlm:aff id="Aff23">National Tuberculosis/Leprosy Control Program, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>National Tuberculosis/Leprosy Control Program, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Ceesay, Samba" sort="Ceesay, Samba" uniqKey="Ceesay S" first="Samba" last="Ceesay">Samba Ceesay</name><affiliation wicri:level="1"><nlm:aff id="Aff24">Health Services, Ministry of Health and Social Welfare, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Health Services, Ministry of Health and Social Welfare, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Adetifa, Ifedayo" sort="Adetifa, Ifedayo" uniqKey="Adetifa I" first="Ifedayo" last="Adetifa">Ifedayo Adetifa</name><affiliation wicri:level="1"><nlm:aff id="Aff17">Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff18">Disease Control and Elimination, Medical Research Council Unit, Serrekunda, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Disease Control and Elimination, Medical Research Council Unit, Serrekunda</wicri:regionArea></affiliation></author><author><name sortKey="Jaye, Assan" sort="Jaye, Assan" uniqKey="Jaye A" first="Assan" last="Jaye">Assan Jaye</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Pallen, Mark J" sort="Pallen, Mark J" uniqKey="Pallen M" first="Mark J." last="Pallen">Mark J. Pallen</name><affiliation wicri:level="1"><nlm:aff id="Aff15">Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry</wicri:regionArea></affiliation></author><author><name sortKey="D Lessandro, Umberto" sort="D Lessandro, Umberto" uniqKey="D Lessandro U" first="Umberto" last="D Lessandro">Umberto D Lessandro</name><affiliation wicri:level="1"><nlm:aff id="Aff16">Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff18">Disease Control and Elimination, Medical Research Council Unit, Serrekunda, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Disease Control and Elimination, Medical Research Council Unit, Serrekunda</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff19">Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Kampmann, Beate" sort="Kampmann, Beate" uniqKey="Kampmann B" first="Beate" last="Kampmann">Beate Kampmann</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff20">Department of Paediatrics, Imperial College London, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Paediatrics, Imperial College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Adegbola, Richard A" sort="Adegbola, Richard A" uniqKey="Adegbola R" first="Richard A." last="Adegbola">Richard A. Adegbola</name><affiliation wicri:level="1"><nlm:aff id="Aff21">GSK Vaccines, Wavre, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>GSK Vaccines, Wavre</wicri:regionArea></affiliation></author><author><name sortKey="Mboup, Souleymane" sort="Mboup, Souleymane" uniqKey="Mboup S" first="Souleymane" last="Mboup">Souleymane Mboup</name><affiliation wicri:level="1"><nlm:aff id="Aff11">Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar, Senegal</nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar</wicri:regionArea></affiliation></author><author><name sortKey="Corrah, Tumani" sort="Corrah, Tumani" uniqKey="Corrah T" first="Tumani" last="Corrah">Tumani Corrah</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="De Jong, Bouke C" sort="De Jong, Bouke C" uniqKey="De Jong B" first="Bouke C." last="De Jong">Bouke C. De Jong</name><affiliation wicri:level="1"><nlm:aff id="Aff19">Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Antonio, Martin" sort="Antonio, Martin" uniqKey="Antonio M" first="Martin" last="Antonio">Martin Antonio</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff15">Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff17">Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27806714</idno><idno type="pmc">5094099</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094099</idno><idno type="RBID">PMC:5094099</idno><idno type="doi">10.1186/s12916-016-0704-5</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000102</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000102</idno><idno type="wicri:Area/Pmc/Curation">000101</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000101</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The emerging threat of pre-extensively drug-resistant tuberculosis in West Africa: preparing for large-scale tuberculosis research and drug resistance surveillance</title><author><name sortKey="Gehre, Florian" sort="Gehre, Florian" uniqKey="Gehre F" first="Florian" last="Gehre">Florian Gehre</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff19">Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Otu, Jacob" sort="Otu, Jacob" uniqKey="Otu J" first="Jacob" last="Otu">Jacob Otu</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Kendall, Lindsay" sort="Kendall, Lindsay" uniqKey="Kendall L" first="Lindsay" last="Kendall">Lindsay Kendall</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Forson, Audrey" sort="Forson, Audrey" uniqKey="Forson A" first="Audrey" last="Forson">Audrey Forson</name><affiliation wicri:level="1"><nlm:aff id="Aff2">University of Ghana Medical School, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>University of Ghana Medical School, Accra</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Kwara, Awewura" sort="Kwara, Awewura" uniqKey="Kwara A" first="Awewura" last="Kwara">Awewura Kwara</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author><author><name sortKey="Kudzawu, Samuel" sort="Kudzawu, Samuel" uniqKey="Kudzawu S" first="Samuel" last="Kudzawu">Samuel Kudzawu</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Kehinde, Aderemi O" sort="Kehinde, Aderemi O" uniqKey="Kehinde A" first="Aderemi O." last="Kehinde">Aderemi O. Kehinde</name><affiliation wicri:level="1"><nlm:aff id="Aff6">College of Medicine, University of Ibadan, Ibadan, Nigeria</nlm:aff><country xml:lang="fr">Nigeria</country><wicri:regionArea>College of Medicine, University of Ibadan, Ibadan</wicri:regionArea></affiliation><affiliation><nlm:aff id="Aff7">University College Hospital, Ibadan, Oyo 23402 Nigeria</nlm:aff><wicri:noCountry code="subfield">Oyo 23402 Nigeria</wicri:noCountry></affiliation></author><author><name sortKey="Adebiyi, Oludele" sort="Adebiyi, Oludele" uniqKey="Adebiyi O" first="Oludele" last="Adebiyi">Oludele Adebiyi</name><affiliation><nlm:aff id="Aff7">University College Hospital, Ibadan, Oyo 23402 Nigeria</nlm:aff><wicri:noCountry code="subfield">Oyo 23402 Nigeria</wicri:noCountry></affiliation></author><author><name sortKey="Salako, Kayode" sort="Salako, Kayode" uniqKey="Salako K" first="Kayode" last="Salako">Kayode Salako</name><affiliation><nlm:aff id="Aff7">University College Hospital, Ibadan, Oyo 23402 Nigeria</nlm:aff><wicri:noCountry code="subfield">Oyo 23402 Nigeria</wicri:noCountry></affiliation></author><author><name sortKey="Baldeh, Ignatius" sort="Baldeh, Ignatius" uniqKey="Baldeh I" first="Ignatius" last="Baldeh">Ignatius Baldeh</name><affiliation wicri:level="1"><nlm:aff id="Aff8">National Public Health Laboratory Services, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>National Public Health Laboratory Services, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Jallow, Aisha" sort="Jallow, Aisha" uniqKey="Jallow A" first="Aisha" last="Jallow">Aisha Jallow</name><affiliation wicri:level="1"><nlm:aff id="Aff8">National Public Health Laboratory Services, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>National Public Health Laboratory Services, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Jallow, Mamadou" sort="Jallow, Mamadou" uniqKey="Jallow M" first="Mamadou" last="Jallow">Mamadou Jallow</name><affiliation wicri:level="1"><nlm:aff id="Aff8">National Public Health Laboratory Services, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>National Public Health Laboratory Services, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Dagnra, Anoumou" sort="Dagnra, Anoumou" uniqKey="Dagnra A" first="Anoumou" last="Dagnra">Anoumou Dagnra</name><affiliation wicri:level="1"><nlm:aff id="Aff9">Laboratoire National de Reference Mycobacteria, Lome, Togo</nlm:aff><country xml:lang="fr">Togo</country><wicri:regionArea>Laboratoire National de Reference Mycobacteria, Lome</wicri:regionArea></affiliation></author><author><name sortKey="Disse, Kodjo" sort="Disse, Kodjo" uniqKey="Disse K" first="Kodjo" last="Dissé">Kodjo Dissé</name><affiliation wicri:level="1"><nlm:aff id="Aff9">Laboratoire National de Reference Mycobacteria, Lome, Togo</nlm:aff><country xml:lang="fr">Togo</country><wicri:regionArea>Laboratoire National de Reference Mycobacteria, Lome</wicri:regionArea></affiliation></author><author><name sortKey="Kadanga, Essosimna A" sort="Kadanga, Essosimna A" uniqKey="Kadanga E" first="Essosimna A." last="Kadanga">Essosimna A. Kadanga</name><affiliation wicri:level="1"><nlm:aff id="Aff9">Laboratoire National de Reference Mycobacteria, Lome, Togo</nlm:aff><country xml:lang="fr">Togo</country><wicri:regionArea>Laboratoire National de Reference Mycobacteria, Lome</wicri:regionArea></affiliation></author><author><name sortKey="Idigbe, Emmanuel Oni" sort="Idigbe, Emmanuel Oni" uniqKey="Idigbe E" first="Emmanuel Oni" last="Idigbe">Emmanuel Oni Idigbe</name><affiliation wicri:level="1"><nlm:aff id="Aff10">Nigerian Institute of Medical Research, Lagos, Nigeria</nlm:aff><country xml:lang="fr">Nigeria</country><wicri:regionArea>Nigerian Institute of Medical Research, Lagos</wicri:regionArea></affiliation></author><author><name sortKey="Onubogu, Catherine" sort="Onubogu, Catherine" uniqKey="Onubogu C" first="Catherine" last="Onubogu">Catherine Onubogu</name><affiliation wicri:level="1"><nlm:aff id="Aff10">Nigerian Institute of Medical Research, Lagos, Nigeria</nlm:aff><country xml:lang="fr">Nigeria</country><wicri:regionArea>Nigerian Institute of Medical Research, Lagos</wicri:regionArea></affiliation></author><author><name sortKey="Onyejepu, Nneka" sort="Onyejepu, Nneka" uniqKey="Onyejepu N" first="Nneka" last="Onyejepu">Nneka Onyejepu</name><affiliation wicri:level="1"><nlm:aff id="Aff10">Nigerian Institute of Medical Research, Lagos, Nigeria</nlm:aff><country xml:lang="fr">Nigeria</country><wicri:regionArea>Nigerian Institute of Medical Research, Lagos</wicri:regionArea></affiliation></author><author><name sortKey="Gaye Diallo, Aissatou" sort="Gaye Diallo, Aissatou" uniqKey="Gaye Diallo A" first="Aissatou" last="Gaye-Diallo">Aissatou Gaye-Diallo</name><affiliation wicri:level="1"><nlm:aff id="Aff11">Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar, Senegal</nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar</wicri:regionArea></affiliation></author><author><name sortKey="Ba Diallo, Awa" sort="Ba Diallo, Awa" uniqKey="Ba Diallo A" first="Awa" last="Ba-Diallo">Awa Ba-Diallo</name><affiliation wicri:level="1"><nlm:aff id="Aff11">Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar, Senegal</nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar</wicri:regionArea></affiliation></author><author><name sortKey="Rabna, Paulo" sort="Rabna, Paulo" uniqKey="Rabna P" first="Paulo" last="Rabna">Paulo Rabna</name><affiliation wicri:level="1"><nlm:aff id="Aff12">National Institute of Public Health, Bissau, Guinea-Bissau</nlm:aff><country xml:lang="fr">Guinée-Bissau</country><wicri:regionArea>National Institute of Public Health, Bissau</wicri:regionArea></affiliation></author><author><name sortKey="Mane, Morto" sort="Mane, Morto" uniqKey="Mane M" first="Morto" last="Mane">Morto Mane</name><affiliation wicri:level="1"><nlm:aff id="Aff12">National Institute of Public Health, Bissau, Guinea-Bissau</nlm:aff><country xml:lang="fr">Guinée-Bissau</country><wicri:regionArea>National Institute of Public Health, Bissau</wicri:regionArea></affiliation></author><author><name sortKey="Sanogo, Moumine" sort="Sanogo, Moumine" uniqKey="Sanogo M" first="Moumine" last="Sanogo">Moumine Sanogo</name><affiliation wicri:level="1"><nlm:aff id="Aff13">SEREFO Program, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali</nlm:aff><country xml:lang="fr">Mali</country><wicri:regionArea>SEREFO Program, University of Sciences, Techniques and Technologies of Bamako, Bamako</wicri:regionArea></affiliation></author><author><name sortKey="Diarra, Bassirou" sort="Diarra, Bassirou" uniqKey="Diarra B" first="Bassirou" last="Diarra">Bassirou Diarra</name><affiliation wicri:level="1"><nlm:aff id="Aff13">SEREFO Program, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali</nlm:aff><country xml:lang="fr">Mali</country><wicri:regionArea>SEREFO Program, University of Sciences, Techniques and Technologies of Bamako, Bamako</wicri:regionArea></affiliation></author><author><name sortKey="Dezemon, Zingue" sort="Dezemon, Zingue" uniqKey="Dezemon Z" first="Zingue" last="Dezemon">Zingue Dezemon</name><affiliation wicri:level="1"><nlm:aff id="Aff14">Centre Muraz and the National TB Program, Ouagadougou, Burkina Faso</nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre Muraz and the National TB Program, Ouagadougou</wicri:regionArea></affiliation></author><author><name sortKey="Sanou, Adama" sort="Sanou, Adama" uniqKey="Sanou A" first="Adama" last="Sanou">Adama Sanou</name><affiliation wicri:level="1"><nlm:aff id="Aff14">Centre Muraz and the National TB Program, Ouagadougou, Burkina Faso</nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre Muraz and the National TB Program, Ouagadougou</wicri:regionArea></affiliation></author><author><name sortKey="Senghore, Madikay" sort="Senghore, Madikay" uniqKey="Senghore M" first="Madikay" last="Senghore">Madikay Senghore</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff15">Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry</wicri:regionArea></affiliation></author><author><name sortKey="Kwambana Adams, Brenda A" sort="Kwambana Adams, Brenda A" uniqKey="Kwambana Adams B" first="Brenda A." last="Kwambana-Adams">Brenda A. Kwambana-Adams</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff16">Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation></author><author><name sortKey="Demba, Edward" sort="Demba, Edward" uniqKey="Demba E" first="Edward" last="Demba">Edward Demba</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Faal Jawara, Tutty" sort="Faal Jawara, Tutty" uniqKey="Faal Jawara T" first="Tutty" last="Faal-Jawara">Tutty Faal-Jawara</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Kumar, Samrat" sort="Kumar, Samrat" uniqKey="Kumar S" first="Samrat" last="Kumar">Samrat Kumar</name><affiliation wicri:level="1"><nlm:aff id="Aff19">Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Tientcheu, Leopold D" sort="Tientcheu, Leopold D" uniqKey="Tientcheu L" first="Leopold D." last="Tientcheu">Leopold D. Tientcheu</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff22">Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Jallow, Adama" sort="Jallow, Adama" uniqKey="Jallow A" first="Adama" last="Jallow">Adama Jallow</name><affiliation wicri:level="1"><nlm:aff id="Aff23">National Tuberculosis/Leprosy Control Program, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>National Tuberculosis/Leprosy Control Program, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Ceesay, Samba" sort="Ceesay, Samba" uniqKey="Ceesay S" first="Samba" last="Ceesay">Samba Ceesay</name><affiliation wicri:level="1"><nlm:aff id="Aff24">Health Services, Ministry of Health and Social Welfare, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Health Services, Ministry of Health and Social Welfare, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Adetifa, Ifedayo" sort="Adetifa, Ifedayo" uniqKey="Adetifa I" first="Ifedayo" last="Adetifa">Ifedayo Adetifa</name><affiliation wicri:level="1"><nlm:aff id="Aff17">Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff18">Disease Control and Elimination, Medical Research Council Unit, Serrekunda, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Disease Control and Elimination, Medical Research Council Unit, Serrekunda</wicri:regionArea></affiliation></author><author><name sortKey="Jaye, Assan" sort="Jaye, Assan" uniqKey="Jaye A" first="Assan" last="Jaye">Assan Jaye</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="Pallen, Mark J" sort="Pallen, Mark J" uniqKey="Pallen M" first="Mark J." last="Pallen">Mark J. Pallen</name><affiliation wicri:level="1"><nlm:aff id="Aff15">Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry</wicri:regionArea></affiliation></author><author><name sortKey="D Lessandro, Umberto" sort="D Lessandro, Umberto" uniqKey="D Lessandro U" first="Umberto" last="D Lessandro">Umberto D Lessandro</name><affiliation wicri:level="1"><nlm:aff id="Aff16">Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff18">Disease Control and Elimination, Medical Research Council Unit, Serrekunda, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Disease Control and Elimination, Medical Research Council Unit, Serrekunda</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff19">Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Kampmann, Beate" sort="Kampmann, Beate" uniqKey="Kampmann B" first="Beate" last="Kampmann">Beate Kampmann</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff20">Department of Paediatrics, Imperial College London, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Paediatrics, Imperial College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Adegbola, Richard A" sort="Adegbola, Richard A" uniqKey="Adegbola R" first="Richard A." last="Adegbola">Richard A. Adegbola</name><affiliation wicri:level="1"><nlm:aff id="Aff21">GSK Vaccines, Wavre, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>GSK Vaccines, Wavre</wicri:regionArea></affiliation></author><author><name sortKey="Mboup, Souleymane" sort="Mboup, Souleymane" uniqKey="Mboup S" first="Souleymane" last="Mboup">Souleymane Mboup</name><affiliation wicri:level="1"><nlm:aff id="Aff11">Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar, Senegal</nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar</wicri:regionArea></affiliation></author><author><name sortKey="Corrah, Tumani" sort="Corrah, Tumani" uniqKey="Corrah T" first="Tumani" last="Corrah">Tumani Corrah</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation></author><author><name sortKey="De Jong, Bouke C" sort="De Jong, Bouke C" uniqKey="De Jong B" first="Bouke C." last="De Jong">Bouke C. De Jong</name><affiliation wicri:level="1"><nlm:aff id="Aff19">Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Antonio, Martin" sort="Antonio, Martin" uniqKey="Antonio M" first="Martin" last="Antonio">Martin Antonio</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff15">Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff17">Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Medicine</title><idno type="eISSN">1741-7015</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Drug-resistant tuberculosis (TB) is a global public health problem. Adequate management requires baseline drug-resistance prevalence data. In West Africa, due to a poor laboratory infrastructure and inadequate capacity, such data are scarce. Therefore, the true extent of drug-resistant TB was hitherto undetermined. In 2008, a new research network, the West African Network of Excellence for Tuberculosis, AIDS and Malaria (WANETAM), was founded, comprising nine study sites from eight West African countries (Burkina Faso, The Gambia, Ghana, Guinea-Bissau, Mali, Nigeria, Senegal and Togo). The goal was to establish Good Clinical Laboratory Practice (GCLP) principles and build capacity in standardised smear microscopy and mycobacterial culture across partnering laboratories to generate the first comprehensive West African drug-resistance data.</p></sec><sec><title>Methods</title><p>Following GCLP and laboratory training sessions, TB isolates were collected at sentinel referral sites between 2009–2013 and tested for first- and second-line drug resistance.</p></sec><sec><title>Results</title><p>From the analysis of 974 isolates, an unexpectedly high prevalence of multi-drug-resistant (MDR) strains was found in new (6 %) and retreatment patients (35 %) across all sentinel sites, with the highest prevalence amongst retreatment patients in Bamako, Mali (59 %) and the two Nigerian sites in Ibadan and Lagos (39 % and 66 %). In Lagos, MDR is already spreading actively amongst 32 % of new patients. Pre-extensively drug-resistant (pre-XDR) isolates are present in all sites, with Ghana showing the highest proportion (35 % of MDR). In Ghana and Togo, pre-XDR isolates are circulating amongst new patients.</p></sec><sec><title>Conclusions</title><p>West African drug-resistance prevalence poses a previously underestimated, yet serious public health threat, and our estimates obtained differ significantly from previous World Health Organisation (WHO) estimates. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Med</journal-id><journal-id journal-id-type="iso-abbrev">BMC Med</journal-id><journal-title-group><journal-title>BMC Medicine</journal-title></journal-title-group><issn pub-type="epub">1741-7015</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27806714</article-id><article-id pub-id-type="pmc">5094099</article-id><article-id pub-id-type="publisher-id">704</article-id><article-id pub-id-type="doi">10.1186/s12916-016-0704-5</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>The emerging threat of pre-extensively drug-resistant tuberculosis in West Africa: preparing for large-scale tuberculosis research and drug resistance surveillance</article-title></title-group><contrib-group><contrib 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contrib-type="author"><name><surname>Onyejepu</surname><given-names>Nneka</given-names></name><xref ref-type="aff" rid="Aff10">10</xref></contrib><contrib contrib-type="author"><name><surname>Gaye-Diallo</surname><given-names>Aissatou</given-names></name><xref ref-type="aff" rid="Aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Ba-Diallo</surname><given-names>Awa</given-names></name><xref ref-type="aff" rid="Aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Rabna</surname><given-names>Paulo</given-names></name><xref ref-type="aff" rid="Aff12">12</xref></contrib><contrib contrib-type="author"><name><surname>Mane</surname><given-names>Morto</given-names></name><xref ref-type="aff" rid="Aff12">12</xref></contrib><contrib contrib-type="author"><name><surname>Sanogo</surname><given-names>Moumine</given-names></name><xref ref-type="aff" rid="Aff13">13</xref></contrib><contrib contrib-type="author"><name><surname>Diarra</surname><given-names>Bassirou</given-names></name><xref ref-type="aff" rid="Aff13">13</xref></contrib><contrib contrib-type="author"><name><surname>Dezemon</surname><given-names>Zingue</given-names></name><xref ref-type="aff" rid="Aff14">14</xref></contrib><contrib contrib-type="author"><name><surname>Sanou</surname><given-names>Adama</given-names></name><xref ref-type="aff" rid="Aff14">14</xref></contrib><contrib contrib-type="author"><name><surname>Senghore</surname><given-names>Madikay</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff15">15</xref></contrib><contrib contrib-type="author"><name><surname>Kwambana-Adams</surname><given-names>Brenda A.</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff16">16</xref></contrib><contrib contrib-type="author"><name><surname>Demba</surname><given-names>Edward</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Faal-Jawara</surname><given-names>Tutty</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kumar</surname><given-names>Samrat</given-names></name><xref ref-type="aff" rid="Aff19">19</xref></contrib><contrib contrib-type="author"><name><surname>Tientcheu</surname><given-names>Leopold D.</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff22">22</xref></contrib><contrib contrib-type="author"><name><surname>Jallow</surname><given-names>Adama</given-names></name><xref ref-type="aff" rid="Aff23">23</xref></contrib><contrib contrib-type="author"><name><surname>Ceesay</surname><given-names>Samba</given-names></name><xref ref-type="aff" rid="Aff24">24</xref></contrib><contrib contrib-type="author"><name><surname>Adetifa</surname><given-names>Ifedayo</given-names></name><xref ref-type="aff" rid="Aff17">17</xref><xref ref-type="aff" rid="Aff18">18</xref></contrib><contrib contrib-type="author"><name><surname>Jaye</surname><given-names>Assan</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Pallen</surname><given-names>Mark J.</given-names></name><xref ref-type="aff" rid="Aff15">15</xref></contrib><contrib contrib-type="author"><name><surname>D’Alessandro</surname><given-names>Umberto</given-names></name><xref ref-type="aff" rid="Aff16">16</xref><xref ref-type="aff" rid="Aff18">18</xref><xref ref-type="aff" rid="Aff19">19</xref></contrib><contrib contrib-type="author"><name><surname>Kampmann</surname><given-names>Beate</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff20">20</xref></contrib><contrib contrib-type="author"><name><surname>Adegbola</surname><given-names>Richard A.</given-names></name><xref ref-type="aff" rid="Aff21">21</xref></contrib><contrib contrib-type="author"><name><surname>Mboup</surname><given-names>Souleymane</given-names></name><xref ref-type="aff" rid="Aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Corrah</surname><given-names>Tumani</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>de Jong</surname><given-names>Bouke C.</given-names></name><xref ref-type="aff" rid="Aff19">19</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Antonio</surname><given-names>Martin</given-names></name><address><phone>002204496074</phone><email>mantonio@mrc.gm</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff15">15</xref><xref ref-type="aff" rid="Aff17">17</xref></contrib><aff id="Aff1"><label>1</label>Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia</aff><aff id="Aff2"><label>2</label>University of Ghana Medical School, Accra, Ghana</aff><aff id="Aff3"><label>3</label>Korle-Bu Teaching Hospital, Accra, Ghana</aff><aff id="Aff4"><label>4</label>Warren Alpert Medical School of Brown University, Providence, RI USA</aff><aff id="Aff5"><label>5</label>The Miriam Hospital, Providence, RI USA</aff><aff id="Aff6"><label>6</label>College of Medicine, University of Ibadan, Ibadan, Nigeria</aff><aff id="Aff7"><label>7</label>University College Hospital, Ibadan, Oyo 23402 Nigeria</aff><aff id="Aff8"><label>8</label>National Public Health Laboratory Services, Banjul, The Gambia</aff><aff id="Aff9"><label>9</label>Laboratoire National de Reference Mycobacteria, Lome, Togo</aff><aff id="Aff10"><label>10</label>Nigerian Institute of Medical Research, Lagos, Nigeria</aff><aff id="Aff11"><label>11</label>Laboratoire Bactériologie Virologie Aristide Le Dantec Sénégal, Dakar, Senegal</aff><aff id="Aff12"><label>12</label>National Institute of Public Health, Bissau, Guinea-Bissau</aff><aff id="Aff13"><label>13</label>SEREFO Program, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali</aff><aff id="Aff14"><label>14</label>Centre Muraz and the National TB Program, Ouagadougou, Burkina Faso</aff><aff id="Aff15"><label>15</label>Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK</aff><aff id="Aff16"><label>16</label>Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK</aff><aff id="Aff17"><label>17</label>Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK</aff><aff id="Aff18"><label>18</label>Disease Control and Elimination, Medical Research Council Unit, Serrekunda, The Gambia</aff><aff id="Aff19"><label>19</label>Institute of Tropical Medicine, Antwerp, Belgium</aff><aff id="Aff20"><label>20</label>Department of Paediatrics, Imperial College London, London, UK</aff><aff id="Aff21"><label>21</label>GSK Vaccines, Wavre, Belgium</aff><aff id="Aff22"><label>22</label>Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon</aff><aff id="Aff23"><label>23</label>National Tuberculosis/Leprosy Control Program, Banjul, The Gambia</aff><aff id="Aff24"><label>24</label>Health Services, Ministry of Health and Social Welfare, Banjul, The Gambia</aff></contrib-group><pub-date pub-type="epub"><day>3</day><month>11</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>3</day><month>11</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>14</volume><elocation-id>160</elocation-id><history><date date-type="received"><day>6</day><month>8</month><year>2016</year></date><date date-type="accepted"><day>28</day><month>9</month><year>2016</year></date></history><permissions><copyright-statement>© The Author(s). 2016</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Drug-resistant tuberculosis (TB) is a global public health problem. Adequate management requires baseline drug-resistance prevalence data. In West Africa, due to a poor laboratory infrastructure and inadequate capacity, such data are scarce. Therefore, the true extent of drug-resistant TB was hitherto undetermined. In 2008, a new research network, the West African Network of Excellence for Tuberculosis, AIDS and Malaria (WANETAM), was founded, comprising nine study sites from eight West African countries (Burkina Faso, The Gambia, Ghana, Guinea-Bissau, Mali, Nigeria, Senegal and Togo). The goal was to establish Good Clinical Laboratory Practice (GCLP) principles and build capacity in standardised smear microscopy and mycobacterial culture across partnering laboratories to generate the first comprehensive West African drug-resistance data.</p></sec><sec><title>Methods</title><p>Following GCLP and laboratory training sessions, TB isolates were collected at sentinel referral sites between 2009–2013 and tested for first- and second-line drug resistance.</p></sec><sec><title>Results</title><p>From the analysis of 974 isolates, an unexpectedly high prevalence of multi-drug-resistant (MDR) strains was found in new (6 %) and retreatment patients (35 %) across all sentinel sites, with the highest prevalence amongst retreatment patients in Bamako, Mali (59 %) and the two Nigerian sites in Ibadan and Lagos (39 % and 66 %). In Lagos, MDR is already spreading actively amongst 32 % of new patients. Pre-extensively drug-resistant (pre-XDR) isolates are present in all sites, with Ghana showing the highest proportion (35 % of MDR). In Ghana and Togo, pre-XDR isolates are circulating amongst new patients.</p></sec><sec><title>Conclusions</title><p>West African drug-resistance prevalence poses a previously underestimated, yet serious public health threat, and our estimates obtained differ significantly from previous World Health Organisation (WHO) estimates. Therefore, our data are reshaping current concepts and are essential in informing WHO and public health strategists to implement urgently needed surveillance and control interventions in West Africa.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Tuberculosis</kwd><kwd>Extensively drug-resistant tuberculosis</kwd><kwd>West Africa</kwd><kwd>Drug-resistance surveillance</kwd><kwd>Capacity building</kwd></kwd-group><funding-group><award-group><funding-source><institution>EDTCP</institution></funding-source><award-id>CB. 2007. 41700.007</award-id></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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