Evaluation of the Management of Drug-Resistant Pulmonary Tuberculosis at the Matam Tuberculosis Center, Conakry, Guinea

Abstract

Background and Aims: Tuberculosis remains a major public health problem, and the emergence of drug-resistant forms significantly complicates its management, particularly in resource-limited countries such as the Republic of Guinea. Thus, this study is to assess the management of patients with drug-resistant pulmonary tuberculosis at the Matam Tuberculosis Center (CAT), in order to identify shortcomings and propose areas for improvement. Methodology: During 12 months, a descriptive and analytical cross-sectional study was conducted at the Matam Tuberculosis Center (CAT). Sociodemographic, clinical, bacteriological, and treatment-related data were collected. A total of 152 sputum samples were analyzed using the GeneXpert MTB/RIF assay and fluorescence microscopy. Results: Among the152 pulmonary tuberculosis patients, GeneXpert MTB/RIF detected 32% of cases compared to 22% by fluorescence microscopy, confirming its superior diagnostic performance. Hematological findings revealed a high prevalence of anemia (98%), mainly microcytic along with leukocytosis and lymphopenia, reflecting chronic inflammation and immune alterations. Biochemical abnormalities, including elevated transaminases and creatinine (31%), suggest treatment-related hepatic and renal effects. The treatment success rate reached 94%, exceeding WHO targets, indicating effective patient management despite persistent challenges related to drug resistance and adherence. Conclusion: Drug-resistant tuberculosis remains a major challenge in Conakry. Strengthening early detection, improving treatment monitoring, and ensuring strict adherence to treatment protocols are essential to improving patient care.