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Home / Tuberculosis / Drug Resistant TB




DRUG RESISTANT TB



PROGRAMMATIC MANAGEMENT OF DRUG RESISTANT TB

Tanzania a low MDR-TB burden country according to the drug resistance survey
conducted in 2017/2018 with results showing overall prevalence of MDR -TB of
1.2%. The highest burden is recorded previous treated TB patients where the
prevalence 4.6% and 0.97% among new TB patients. The MDR-TB burden has remained
stable for over a decade as compared to the previous survey conducted in
2006/2007 where the prevalence was 1.1 and 3.9% in new and previous treated TB
patients respectively. 

MDR-TB CASES NOTIFICATION

For the past 7 years there have been an overall upward trend in
RR/MDR/Pre-XDR-TB notification with a slight drop in notification between 2019
and 2021. This trend is also reflected in number of patients enrolled to
treatment among notified patients in the same period which ranged from 67% in
2015 to 99% in 2021.  In the 2021 the number of RR/MDR/Pre-XDR-TB patients
notified is 442, out of these 6 are Pre-XDR -TB patients who are RR/MDR-TB with
additional resistance to Fluoroquinolone one of the key medicines used in MDR-TB
treatment.  The notified patients included 6 paediatric RR-TB patients. Among
the notified patients 438 (99%) were enrolled into MDR-TB treatment in 2021.
RR/MDR TB notification is below the programme target where it has achieved 56%
of notification target of 800 RR/MDR -TB patients in 2021. 

Figure 16: Trend on RR/ MDR-TB notified and enrolled to treatment 2015 - 2021



The notification varies from region to region; Dar es salaam notified largest
proportion of 87 (20%), followed by Morogoro 31 (7%), Lindi 29 (6.6%), Arusha
21(5%), and Manyara 22 (5%) remaining regions notified at least 1 patient except
Pemba did not have any RR/MDR TB patient in 2021. 

Figure 17: Trend on RR/ MDR-TB notified and enrolled to treatment 2021 by region



TREND ON RR/ MDR-TB NOTIFIED AND ENROLLED TO TREATMENT 2015 - 2021

The notification varies from region to region; Dar es salaam notified largest
proportion of 85 (19%), followed by Morogoro 31 (7%) 29 (6%), Arusha 22(5%), and
Manyara 22 (5%) remaining regions notified at least 1 patient except Pemba did
not have a RR/MDR TB patient in 2021. 

DECENTRALIZATION OF DR-TB PATIENT CARE

Since 2016 MoH started to decentralise MDR TB services from Kibong’oto
Infectious Diseases Hospital which was the only centre initiating treatment to
RR/MDR TB patients. The number of health facilities initiating DR-TB treatment
has increased up to 304 by the end of 2021.  Out of these six health facilities
(Kibong’oto, Bugando, Muhimbili National Hospital, Dodoma Regional Referral
Hospital, Sumbawanga Regional Referral Hospital and Mbinga District Hospital has
capacity to admit patients who cannot be managed on ambulatory basis.

MDR-TB TREATMENT OUTCOMES ENROLLED IN 2019

Among 518 patients enrolled to long and short MDR TB treatment in 2019; 378
(73.0%) were successfully treated (cured + treatment completed). Those with
unfavourable outcome includes 99 (19%) patients who died, 28 (5%) patients were
lost to follow up and 1 patient failed treatment. However, there were 12
patients who were not evaluated among the 518 and were included in denominator
during calculation of proportion of the results above. Stratification by
treatment regimen indicates that patient enrolled in shorter treatment regimen
(injectable based) 199 had treatment success of 80% while 229 patients enrolled
in longer regimens had treatment success of 63%. This partly can be explained by
the eligibility criteria for enrolment into the shorter regimen which excludes
severely ill patients. The treatment success rate has declined from 83% in 2017
to 73% in 2019.

 




TUBERCULOSIS

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 * TB in Mining Sector (TIMS)


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