DEVELOPING A MODEL FOR PREDICTING BEDAQUILINE RESISTANCE IN MDR TB

In Africa there is a growing prevalence of multi drug resistant mycobacterium Tuboculare, the organism causing tuberculosis. Many factors have led to this including the toxicity of anti TB medications and the prolonged duration of treatment. This further worsens when treating drug resistant TB. Introduction of short term drug resistant TB regimens curbed these challenges. Bedaquiline is among the drugs of these shorter duration regimens and was hailed as a landmark drug to treat many forms of DR-TB. Its use required initial resistant testing but this was not the case and eventually lead to mass use without confirming its susceptibility. Phenotypic drug susceptibility testing should be done before commencing bedaquiline containing regimen. The current laboratory infrastructure and expertise are wanting; further contributing to emergence of resistant variants. Eventually this game changing drug is facing it post effectiveness period in the current DR-TB variants we face. We propose to use the dataset to come up with a model for predicting bedaquiline DR-TB for both patient factors and health system factors so that we can confirm the postulated causes of resistance and propose measures to mitigate them.