Volume 84, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



In resource-constrained environments, monitoring the occurrence of tuberculosis (TB), human immunodeficiency virus (HIV), or malaria resistant to the limited number of available drugs is essential for national treatment program success. Countries with limited resources and technical capacity rely on survey designs and methods that are simple and easily integrated into routine clinical activities to minimize the impact on overburdened clinics. This paper reviews the most commonly used methods for drug-resistance surveillance of TB, HIV, and malaria and discusses the strengths and limitations of these different strategies.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Roll Back Malaria, 2008. Executive Summary: The Global Malaria Action Plan. Available at: http://rbm.who.int/gmap/0-5.pdf. Accessed October 6, 2009. [Google Scholar]
  2. The Joint United Nations Programme on HIV/AIDS (UNAIDS), 2008. '08 Report on the Global AIDS Epidemic. Available at: http://data.unaids.org/pub/GlobalReport/2008/jc1510_2008globalreport_en.pdf. Accessed October 6, 2009. [Google Scholar]
  3. World Health Organization, 2008. World Malaria Report 2008. Available at: http://apps.who.int/malaria/wmr2008/malaria2008.pdf. Accessed October 6, 2009. [Google Scholar]
  4. World Health Organization, 2008. Global Tuberculosis Control 2008: Surveillance, Financing and Planning. Available at: http://www.who.int/tb/publications/global_report/2008/. Accessed October 6, 2009. [Google Scholar]
  5. UNAIDS, 2009. 2008 UNAIDS Annual Report: Towards Universal Access. Available at: http://data.unaids.org/pub/Report/2009/jc1736_2008_annual_report_en.pdf. Accessed October 6, 2009. [Google Scholar]
  6. Bennett DE, Bertagnolio S, Sutherland D, Gilks CF, , 2008. The World Health Organization's global strategy for prevention and assessment of HIV Drug resistance. Antivir Ther 13 (Suppl 2): 113. [Google Scholar]
  7. Bennett DE, Myatt M, Bertagnolio S, Sutherland D, Gilks CF, , 2008. Recommendations for surveillance of transmitted drug resistance in countries scaling up antiretroviral treatment. Antivir Ther 13 (Suppl 2): 2536. [Google Scholar]
  8. Jordan MR, Bennett DE, Bertagnolio S, Gilks CF, Sutherland D, , 2008. World Health Organization surveys to monitor HIV Drug resistance prevention and associated factors in sentinel antiretroviral treatment sites. Antivir Ther 13 (Suppl 2): 1523. [Google Scholar]
  9. World Health Organization, 2008. HIV Drug Resistance Early Warning Indicators: World Health Organization Indicators to Monitor HIV Drug Resistance Prevention at Antiretroviral Treatment Sites. Geneva, Switzerland: World Health Organization. [Google Scholar]
  10. World Health Organization, 2009. Methods for Surveillance of Antimalarial Drug Efficacy. Available at: http://apps.who.int/malaria/docs/drugresistance/Protocol2009.pdf. Accessed October 7, 2009. [Google Scholar]
  11. World Health Organization, 2009. Guidelines for Surveillance of Drug Resistance in Tuberculosis, 4th ed. Available at: http://whqlibdoc.who.int/publications/2009/9789241598675_eng.pdf. Accessed March 31, 2010. [Google Scholar]
  12. World Health Organization, 2003. Treatment of Tuberculosis: Guidelines for National Treatment Programs. Available at: http://whqlibdoc.who.int/hq/2003/WHO_CDS_TB_2003.313_eng.pdf. Accessed March 1, 2010. [Google Scholar]
  13. World Health Organization, 2006. The Global Plan to Stop TB 2006–2015: Actions for Life, Towards a World Free of Tuberculosis. Available at: http://www.stoptb.org/globalplan/assets/documents/GlobalPlanFinal.pdf. Accessed March 1, 2010. [Google Scholar]
  14. Shafer RW, Rhee S, Pillay D, Miller V, Sandstrom P, Schapiro JM, Kuritzkes DR, Bennett D, , 2007. HIV-1 protease and reverse transcriptase mutations for drug resistance surveillance. AIDS 21: 215223.[Crossref] [Google Scholar]
  15. Bennett DE, Camacho RJ, Otelea D, Kuritzkes DR, Fleury H, Kiuchi M, Heneine W, Kantor R, Jordan MR, Schapiro JM, Vandamme AM, Sandstrom P, Boucher CAB, van de Vijver D, Rhee S, Liu TF, Pillay D, Shafer RW, , 2009. Drug resistance mutations for surveillance of transmitted HIV-1 drug-resistance: 2009 update. PLoS One 4: e4274.[Crossref] [Google Scholar]
  16. Myatt M, Bennett DE, , 2008. A novel sequential sampling technique for the surveillance of transmitted HIV drug resistance by cross-sectional survey for use in low resource settings. Antivir Ther 13 (Suppl 2): 3748. [Google Scholar]
  17. World Health Organization, 2006. Guidelines for the Treatment of Malaria. Available at: http://whqlibdoc.who.int/publications/2006/9241546948_eng_full.pdf. Accessed March 1, 2010. [Google Scholar]
  18. Djimde AA, Duombo OK, Traore O, Guindo AB, Kayentao K, Diourte Y, Niare-Doumbo S, Coulibaly D, Kone AK, Cissoko Y, Tekete M, Fofana B, Dicko A, Diallo DA, Wellems TW, Kwiatkowski D, Plowe CV, , 2003. Clearance of drug-resistant parasites as a model for protective immunity in Plasmodium falciparum malaria. Am J Trop Med Hyg 69: 558563. [Google Scholar]
  19. Koepfli C, Mueller I, Marfurt J, Goroti M, Sie A, Oa O, , 2009. Evaluation of Plasmodium vivax genotyping markers for molecular monitoring in clinical trials. J Infect Dis 199: 10741080.[Crossref] [Google Scholar]
  20. Wells TNC, Alonso PL, Gutteridge WE, , 2009. New medicines to improve control and contribute to the eradication of malaria. Natl Rev 8: 879891. [Google Scholar]
  21. Wright A, Zignol M, Van Deun A, Falzon D, Gerges SR, Feldman K, Hoffner S, Drobniewski F, Barrera L, van Soolingen D, , 2009. Epidemiology of antituberculosis drug resistance 2002–07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance. Lancet 373: 18611873.[Crossref] [Google Scholar]
  22. Abegaz WE, Grossman Z, Wolday D, Ram D, Kaplan J, Sibide K, Wuhib T, Ismael S, Nkengasong J, Mekonen T, Berhanu W, Messele T, Lulseged S, Maayan S, Mengitsu Y, , 2008. Threshold survey evaluating transmitted HIV drug resistance among public antenatal clinic clients in Addis Ababa, Ethiopia. Antivir Ther 13 (Suppl 2): 8994. [Google Scholar]
  23. Hedt BL, Wadonda-Kabondo N, Makombe S, Harries AD, Schouten EJ, Limbambala E, Hochesang M, Aberle-Grasse J, Kamoto K, , 2008. Early warning indicators for HIV drug resistance in Malawi. Antivir Ther 13 (Suppl 2): 6975. [Google Scholar]
  24. Kamoto K, Aberle-Grass J, , Malawi HIV Drug Resistance Task Force , 2008. Surveillance of transmitted HIV drug resistance with the World Health Organization threshold survey method in Lilongwe, Malawi. Antivir Ther 13 (Suppl 2): 8387. [Google Scholar]
  25. Maphalala G, Okello V, Mndzebele S, Gwebu P, Mulima N, Dlamini S, Nhlabatsi B, Ginindza T, Ghebrenegus Y, Ntilivamunda A, Mwanyumba F, Ledwaba J, Pillay V, Bennett DE, , 2008. Surveillance of transmitted HIV drug resistance in the Manzini–Mbabane corridor, Swaziland, in 2006. Antivir Ther 13 (Suppl 2): 95100. [Google Scholar]
  26. Nguyen HT, Duc NB, Shrivastava R, Tran TH, Nguyen TA, Thang PH, McNicholl JM, Leelawiwat W, Chonwattana W, Sidibe K, Fujita M, Luu CMT, Kakkar R, Bennett DE, Kaplan J, Cosimi L, Wolfe MI, , 2008. HIV drug resistance threshold survey suing specimens from voluntary counseling and testing sites in Hanoi, Vietnam. Antivir Ther 13 (Suppl 2): 115121. [Google Scholar]
  27. Pillay V, Ledwaba J, Hunt G, Rakgotho M, Singh B, Makubalo L, Bennett DE, Puren A, Morris L, , 2008. Antiretroviral drug resistance surveillance among drug-naive HIV-1–infected individuals in Gauteng Province, South Africa in 2002 and 2004. Antivir Ther 13 (Suppl 2): 101107. [Google Scholar]
  28. Sirivichayakul S, Phanuphak P, Pankam T, O-Charoen R, Sutherland D, Ruxrungtham K, , 2008. HIV drug resistance transmission threshold survey in Bangkok, Thailand. Antivir Ther 13 (Suppl 2): 109113. [Google Scholar]
  29. Somi GR, Kibuka T, Diallo K, Tuhuma T, Bennett DE, Yang C, Kagoma C, Lyamuya EF, Swai RO, Kassim S, , 2008. Surveillance of transmitted HIV drug resistance among women attending antenatal clinics in Dar es Salaam, Tanzania. Antivir Ther 13 (Suppl 2): 7782. [Google Scholar]
  30. Castillo J, Comegna M, Quijada W, Jauvin V, Pinson P, Masquelier B, Fleury H, Castro E, , 2009. Surveillance of HIV type 1 drug among naïve patients from Venezuela. AIDS Res Hum Retroviruses 25: 13291333.[Crossref] [Google Scholar]
  31. Inocencio LA, Pereira AA, Sucupira MC, Fernandez JC, Jorge CP, Souza DF, Fink HT, Diaz RS, Becker IM, Suffert TA, Arruda MB, Macedo O, Simão MBG, Tanuri A, , 2009. Brazilian network for HIV drug resistance surveillance: a survey of individuals recently diagnosed with HIV. J Int AIDS Soc 12. doi:10.1186/1758-2652-12-20.[Crossref] [Google Scholar]
  32. Ndembi N, Lyagoba F, Kushemererma G, Serwanga J, Katongole-Mbidde E, Grosskurth H, Kaleebu P, , 2008. Transmitted antiretroviral drug resistance surveillance among new HIV type 1-diagnosed women attending antenatal clinic in Entebbe, Uganda. AIDS Res Hum Retroviruses 24: 889895.[Crossref] [Google Scholar]
  33. World Health Organization, 2009. Global Tuberculosis Control 2008: Epidemiology, Financing and Planning. Available at: http://www.who.int/tb/publications/global_report/2009/en/index.html. Accessed March 1, 2010. [Google Scholar]
  34. Zhang J, Kang D, Fu J, Sun X, Lin B, Bi Z, Nkengasong JN, Yang C, , 2010. Surveillance of transmitted HIV type 1 drug resistance in newly diagnosed HIV type 1-infected patients in Shandong Province, China. AIDS Res Hum Retroviruses 26: 99103.[Crossref] [Google Scholar]
  35. Price RN, Dorsey G, Ashley EA, Barnes KI, Baird JK, d'Alessandro U, Guerin PJ, Laufer MK, Naidoo I, Nosten F, Olliaro P, Plowe CV, Ringwald P, Sibley CH, Stepniewska K, White NJ, , 2007. World Antimalarial Resistance Network I: clinical efficacy of antimalarial drugs. Malar J 6: 119.[Crossref] [Google Scholar]
  36. Guerin PJ, Bates SJ, Sibley CH, , 2009. Global resistance surveillance: ensuring antimalarial efficacy in the future. Curr Opin Infect Dis 22: 593600.[Crossref] [Google Scholar]
  37. Laufer MK, Djimde AA, Plowe CV, , 2007. Monitoring and deterring drug-resistant malaria in the era of combination therapy. Am J Trop Med Hyg 77 (Suppl 6): 160169. [Google Scholar]
  38. Cohen T, Hedt BL, Pagano M, , 2010. Estimating the magnitude and direction of bias in tuberculosis drug resistance surveys conducted only in the public sector: a simulation study. BMC Public Health 10. doi:10.1186/1471-2458-10-355.[Crossref] [Google Scholar]
  39. Lillebaek T, Dirksen A, Baess I, Strunge B, Thomsen VO, Andersen AB, , 2002. Molecular evidence of the endogenous reactivation of Mycobacterium tuberculosis after 33 years of latent infection. J Infect Dis 185: 401404.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 25 Jun 2010
  • Accepted : 26 Oct 2010
  • Published online : 04 Feb 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error