Drug resistance and HIV co-infection among pulmonary tuberculosis patients in Haiphong City, Vietnam

SETTING: Vietnam is one of the 22 countries with the highest burden of tuberculosis (TB). Although its National Tuberculosis Programme (NTP) is effective, there is no ongoing surveillance of drug resistance. OBJECTIVE: To establish the first step of a surveillance programme on anti-tuberculosis drug resistance in Haiphong, the third largest city in Vietnam. DESIGN: A regional survey using proportionate cluster sampling in 2006, and recording patients' characteristics, including human immunodeficiency virus (HIV) co-infection. RESULTS: There was a high prevalence of HIV co-infection (14.2%) among culture-positive pulmonary TB patients. The prevalence of drug resistance was high, and it was much higher among previously treated cases than among new cases (52.5% vs. 25.6%), with resistance to streptomycin being the most prevalent. The prevalence of multidrug resistance was high among new cases (4.4%), but was relatively low among previously treated cases (10%). HIV co-infection was related to resistance to rifampicin alone among new cases, but was not a risk factor for any other resistance pattern. CONCLUSION: These results suggest a high prevalence of anti-tuberculosis drug resistance and of HIV co-infection among TB patients in Haiphong. Ongoing surveillance to assess resistance trends is needed, and the NTP needs to coordinate HIV and TB programmes to address the growing issue of TB and HIV co-infection.