Monoresistance to Rifampicin: An Uncharted Territory in The Management of Drug-Resistant Tuberculosis

Abstract

Tuberculosis (TB) disease caused by the bacilli Mycobacterium tuberculosis (MTB) is a chronic disease, mostly involving the lungs but can also involve other parts of the body, which if left untreated may lead to severe illness which can be fatal. Worldwide, TB is the 13th leading cause of death. TB occurs in every part of the world but its distribution is heterogenous. As per WHO global TB report, the biggest quantum of cases occurs in the South and South-Eastern Asian region (46%). Africa contributes to 23% with Western pacific taking 18% of the burden of TB [1].

Multidrug-resistant TB (MDR-TB) which is resistance to both first line drugs Rifampicin, (R) and Isoniazid (H) as well as R(R) TB (Rifampicin resistance with or without H resistance) with incident cases of about 465000 MDR-TB and R(R) TB in 2019, drug-resistant tuberculosis (DR-TB) remains a public health crisis [2]. The cartridge based nucleic acid amplification Test (CBNAAT) can detect Mycobacterium TB and can also provide information on the sensitivity or resistance of Rifampicin.