Publication date: Aug 26, 2026
Approximately 96% of rifampicin resistance/multidrug-resistant tuberculosis (RR/MDR-TB) cases in Rwanda result from direct transmission rather than acquired resistance. However, the nationwide spatial distribution and transmission dynamics of RR/MDR-TB remain poorly characterised. This study aims to analyse spatial patterns of RR/MDR-TB in Rwanda and explore relationships between spatial proximity and RR/MDR-TB strains’ genetic relatedness. We conducted a retrospective analysis of 249 confirmed RR-TB cases across Rwanda from 2017 to 2024, using the known geolocations of patients’ residences. Spatial and space-time clustering was assessed using Kulldorff’s scan statistics. Demographic and socioeconomic determinants were evaluated using multivariable regression. For 201 cases with whole-genome sequencing data, we performed transmission analysis using a 5-SNP threshold to define recent transmission clusters and investigated spatial relationships within genetically related strains. Significant spatial clustering of RR/MDR-TB was identified in 21 sectors, mainly in Nyarugenge, southern Gasabo and western Kicukiro (relative risk: 10. 06; p
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Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | multidrug-resistant tuberculosis |
| drug | DRUGBANK | Rifampicin |
| disease | MESH | strains |
| disease | MESH | tuberculosis |
| pathway | KEGG | Tuberculosis |