Abstract
Study background: Tuberculosis including multi-drug resistant form is not adequately diagnosed in spite of the fact that it constitutes a major public health challenge. This study was carried out to obtain data on laboratory diagnosis of pulmonary tuberculosis at the three local government areas in Osun state, Nigeria. Methods: Six month pilot study was carried out at Iwo, Irewole and Ede North LGAs, all located in Osun state, Nigeria. Socio-demographic and clinical information of the subjects were obtained using a pre-tested questionnaire. Sputum samples were collected from symptomatic pulmonary tuberculosis patients, stained with Zeihl-Neelsen (ZN) reagents and cultured on egg-based Lowenstein-Jensen medium. The medium was incubated at 37°C for eight weeks. Acid Fast Bacilli was confirmed by repeat Z-N staining. Drug resistance testing of the isolates was done using Genotype MTBDRplus. Serum was screened for HIV test using recombinant ELISA. Those that were screened positive were retested using Capillus HIV 1 and 2. Results: Of the 75 subjects studied, seven (9.3%) were over 60 years while the majority, 45 (76.0%) were aged 21-60 years. Thirty-four (45.3%) had their sputum positive for acid fast bacilli (AFB) while 24 (32.0%) were culture positive. Among the 24 isolates, 6 were identified to be non tuberculos mycobacteria (NTM) by molecular methods. The HIV prevalence rate was observed to be 18.6% among all the study participants. Six out of 34 AFB positive persons (17.6%) were also positive for HIV specific antibody, while eight (19.5%) of the AFB negative persons were positive for HIV. There is no significant difference in the incidence of TB between the HIV infected and uninfected groups (p>0.05).Among the 18 mycobacterial isolates (excluding NTM), one strain (5.5%) was found to be resistant to rifampicin and isoniazid (Multi-Drug Resistant-MDR) while three were resistant to isoniazid alone.. Conclusion: This pilot study reveals the existence of MDR-TB and warrants well designed studies to ascertain the magnitude of the problem.
Highlights
Tuberculosis (TB) continues to be a major threat worldwide despite the existence of antituberculosis drugs for the past 60 years [1]
The TB burden in Nigeria is further strengthened by the relative high prevalence of HIV co-infection; as according to the World Health Organization (WHO) [2], about 18% of all TB patients tested were positive for HIV
Consent was sought from 105 participants, of whom 75 subjects (71.4%) gave consent and participated in the study giving a male to female ratio of 0.80 to 1.00 respectively
Summary
Tuberculosis (TB) continues to be a major threat worldwide despite the existence of antituberculosis drugs for the past 60 years [1]. About 80% of the estimated 9.4 million, new TB cases arising each year occur amongst the 22 countries with the highest global TB burden [1]. The TB burden in Nigeria is further strengthened by the relative high prevalence of HIV co-infection; as according to the World Health Organization (WHO) [2], about 18% of all TB patients tested were positive for HIV. Certain important milestones are paramount in the fight to stop the spread of TB globally. These include: early diagnosis, prevention of the spread of the disease, effective treatment with anti-TB drugs and prevention of development of multidrug-resistant bacteria strains. Quick and reliable identification of the causative organism and early detection of drug-resistant strains are prerequisites to the effective treatment and confinement of the disease
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