{
  "abstract": "Madagascar’s first national drug-resistance survey (2005-06) reported multidrug-resistant tuberculosis (MDR-TB) in 0.2% of new and 3.4% of retreatment patients. To generate updated resistance estimates, a national cross-sectional, cluster-randomised survey was conducted across 36 diagnostic and treatment centres between April 2023 and April 2024. Bacteriologically confirmed pulmonary TB patients were enrolled and sputum specimens collected for drug-resistance testing, including culture, line-probe assay, Xpert MTB/RIF Ultra, and phenotypic drug-susceptibility testing. Of 2,250 enrolled patients, 1,987 were new (88.3%) and 263 were previously treated (11.7%). Weighted prevalence of rifampicin resistance was 0.2% (95% CI 0.1–0.7%) among new patients and 3.7% (95% CI 1.7–7.8%) among previously treated patients, reflecting stability since the 2005-06 survey. No pre-XDR or XDR-TB was detected. However, resistance to bedaquiline or linezolid was found in 2 of 40 new patients and 2 of 11 retreatment patients among rifampicin- and/or isoniazid-resistant isolates. Overall, the findings indicate a stable and contained RR-TB burden in Madagascar. Sustaining this outcome will require continued investment in case detection, drug-susceptibility testing, effective treatment, and routine resistance surveillance.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "name": "Rila Ratovoson"
    },
    {
      "name": "Astrid M. Knoblauch"
    },
    {
      "name": "Simon Grandjean Lapierre"
    },
    {
      "name": "Holy N. Andriamamonjisoa"
    },
    {
      "name": "Rado C. Rasoloarisata"
    },
    {
      "name": "Rojovola Randrianarivony"
    },
    {
      "name": "Mamy Serge Raherison"
    },
    {
      "name": "Henry Byabajungu"
    },
    {
      "name": "Hary Seheno Andriambololona"
    },
    {
      "name": "Andrianantenaina Rakotoson"
    },
    {
      "name": "Tojosoa Daniel Ramananjanahary"
    },
    {
      "name": "Rindra Randremanana"
    },
    {
      "name": "Daniella Randriamanana"
    },
    {
      "name": "Richard Mbumba Ngimbi"
    },
    {
      "name": "Eveline Klinkenberg"
    },
    {
      "name": "Michel Tiaray Harison"
    },
    {
      "name": "Niaina Rakotosamimanana"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8hqbm5t2md0ck.bib",
  "cited_by": 0,
  "doi": "10.1038/s41598-026-74038-w",
  "fulltext_url": null,
  "id": "8hqbm5t2md0ck",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://www.nature.com/articles/s41598-026-74038-w",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|Tuberculosis Research and Epidemiology"
    ]
  ],
  "openalex": "W7220983195",
  "pdf_url": "https://www.nature.com/articles/s41598-026-74038-w_reference.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-08",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/8hqbm5t2md0ck.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:24Z",
      "native_id": "10.1038/s41598-026-74038-w",
      "source": "crossref",
      "url": "https://www.nature.com/articles/s41598-026-74038-w"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Tuberculosis Research and Epidemiology",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Low rifampicin and early signs of next-line drug resistances: findings from Madagascar’s 2023–24 nationwide drug resistance survey",
  "title_text": "Low rifampicin and early signs of next-line drug resistances: findings from Madagascar’s 2023–24 nationwide drug resistance survey",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:24Z",
  "url": "https://research.draconitic.com/paper/8hqbm5t2md0ck",
  "venue": "Scientific Reports",
  "versions": []
}