Browsing by Author "Komba, Erick Vitus"

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Drug susceptibility profiles and factors associated with non-tuberculous mycobacteria species circulating among patients diagnosed with pulmonary tuberculosis in Tanzania
(PLoS ONE, 2022) Maya, Togolani Godfrey; Komba, Erick Vitus; Mensah, Gloria Ivy; Mbelele, Peter Masunga; Mpagama, Stella George; Mfinanga, Sayoki Godfrey; Addo, Kennedy Kwasi; Kazwala, Rudovick Reuben
Background While most Non-tuberculous mycobacteria (NTM) are saprophytic, several species have been associated with human diseases, from localized infection to disseminated diseases. Pulmonary NTM infections lead to TB-like disease called NTM pulmonary disease (NTM- PD). Due to variation in treatment options among NTM species, it is necessary to identify the species and determine drug susceptibility profiles to inform the choice of appropriate regimen for the disease. Design A total of 188 culture-positive isolates from patients diagnosed with TB were screened for NTM at the Central Tuberculosis Reference Laboratory. All NTM were further speciated using GenoType® Mycobacterium—Common Mycobacterium and Additional species (GenoType® CM/AS) kit. Mycobacteria avium complex (MAC) and Mycobacteria absces- sus complex (MABC) which could not be identified with the test to species were subjected to GenoType® Mycobacteria NTM-DR for further speciation. Using the same test, identified MAC and MABC were genotyped to determine the drug susceptibility profile for each isolate to macrolide and aminoglycosides. Results Of all isolates identified as mycobacteria, 24 (13%) were NTM. Fifteen isolates could be identified to species level of which prevalent species was M. avium sub. intracellulare 4 (27%). A total of 10 isolates were MAC (n = 6) and MABC (n = 4) were subjected to Geno- Type® Mycobacteria NTM-DR for determination of macrolide and aminoglycoside suscepti- bility. Three of the four MABC had a mutation at the T28 position of the erm (41). All MAC were susceptible to both drugs. Conclusion In this study, MAC was the most frequently isolated NTM species followed by MABC. While all MAC and MABC identified, were susceptible to aminoglycosides, three MABC were resistant to the macrolides due to mutation at position 28 of the erm (41) gene. For this, it is important for clinicians need to rule out NTM, understand species and their drug susceptibil- ity for optimal case management.
Mapping and gap analysis on antimicrobial resistance surveillance systems in Kenya, Tanzania, Uganda and Zambia
(Springer Nature, 2023) Matee, Mecky; Mshana, Stephen E.; Mtebe, Majigo; Komba, Erick Vitus; Moremi, Nyambura; Lutamwa, Julius; Kapona, Otrida; Sekamatte, Musa; Mboera, Leonard E. G.
Background Antimicrobial resistance is a global problem and involve pathogens which have the potential to move between food producing animals and humans by direct exposure or through the food chain or the environment. The objective of this study was to determine the performance in addressing antimicrobial resistance in Kenya, Tanzania, Uganda and Zambia. Desk review and in-depth interviews were employed for data collection. Interviews were con- ducted with national antimicrobial resistance focal officials. Results The findings indicate that in the four countries there was minimal capacity to conduct AMR surveillance. There were few well-established laboratories in tertiary hospitals, both private and public hospitals. The animal, envi- ronment and agricultural sectors in all countries had limited capacity in conducting antimicrobial resistance surveil- lance. There is limited data on antimicrobial resistance in all the four countries, and regional data sharing was limited. In all the four countries, data from research institutions were not linked using standardized system making difficult to compile the national database. The capacity for microbiological culture, identification and antimicrobial sensitivity testing using standardized protocols was available in the four countries. The interventions adopted by the countries included development of National Action Plans on antimicrobial resistance and setting up of multi-sectoral national coordinating structures. Conclusions Based on this findings, the countries need improved National Integrated Antimicrobial Resistance Sur- veillance systems to include community settings, involving antimicrobial use and resistance in human, animal, food, and environment sectors. In addition, the region requires clear antimicrobial resistance data sharing protocol for quick comparability of the data across the region. This is important in driving antimicrobial resistance agendas at regional level, which will eventually trigger collective actions.