High rate of drug-resistant TB in Gabon’s Haut-Ogooué region

Drug-resistant tuberculosis (DR-TB) remains a major global health concern, and researchers set out to measure how big that problem is in one part of Gabon. Led in correspondence by Jabar Babatunde Pacome Agbo Achimi Abdul, the team focused on the Haut-Ogooué region and combined past records with new testing to get a clearer picture. The study ran at the Centre Hospitalier Universitaire de Franceville from August 2022 to August 2024 and included 1,792 people who provided sputum samples for laboratory analysis. The goal was straightforward: determine how common drug resistance is among TB patients in this area and look for factors linked to resistance, such as prior TB treatment, age, sex and HIV status. By collecting both clinical samples and background information on patients, the researchers aimed to connect lab-confirmed resistance patterns with real-world circumstances that could help shape stronger local TB control efforts.

The work combined a retrospective review with prospective testing at a single hospital site. Sputum samples from the 1,792 participants were analyzed using GeneXpert MTB/RIF ULTRA and MTB/XDR assays to detect TB and drug resistance. The team also recorded demographic data, HIV status and previous TB treatment history, and analyzed the information using R software. In this group, 62.1% were male and 85.5% lived in urban areas; nearly half (47.8%) had unknown HIV status. Among resistant isolates, Multidrug-resistant TB (MDR-TB) was the predominant profile, accounting for 94.44% of resistant cases. Statistical testing showed a strong association between having a history of previous TB treatment and drug-resistant TB (p < 0.001). No significant associations were found between drug-resistant TB and either sex or age in this study sample.

Taken together, these findings point to a worrying concentration of MDR-TB in Haut-Ogooué and suggest that prior TB treatment is a key risk factor for resistance in this setting. The high share of MDR-TB among resistant isolates implies that standard first-line therapy may be failing for many patients, and the strong link to previous treatment history highlights the need to review how treatments are given and completed. The fact that nearly half of participants had unknown HIV status and that most patients came from urban areas also suggests gaps in routine care and diagnosis that could hamper TB control. The authors conclude that local and national TB programs should strengthen treatment practices, bolster diagnostic follow-up, and address social determinants that contribute to ongoing transmission and poor outcomes in Gabon.