Diagnostic approaches and prevalence of Rifampicin resistant Mycobacterium tuberculosis in District Mardan

Abstract

The disease tuberculosis (TB) caused by Mycobacterium Tuberculosis (MTB) is most common infectious disease in developing countries. The disease is fatal if not treated during the early stages of infection, thereby early and precise detection is a decisive step in curing the disease. The aim of this study was to analyze the prevalence of tuberculosis in patients reporting to Mardan Medical Complex (MMC), located in the district Mardan, KPK, Pakistan. The sputum of patients was analysed by Ziehl-Nilsen (ZN) staining technique followed by light microscopy called Acid-Fast Bacillus (AFB) staining. The sputum samples were collected from the patients and analysed by special PCR method called GeneXpert MTB/RIF assay, for genomic detection and resistance assay for rifampicin antibiotic were used, are the commonly used medicine for the treatment of MTB infection. Total 121 patients reported to MMC, represented 74 % patients from Mardan, 12% from Nowshera and 14% from Swabi. These patients were screened for the aim to evaluate the techniques for the detection of MTB. The light microscopy method confirmed 66 (55%) of the patients positive for MTB, whereas the same samples reported 78 (68%) patients positive for MTB through GeneXpert MTB/RIF assay, The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) found for light microscopy were 99% and 78.1% respectively. The most used drug rifampicin was found ineffective in 9 patients (7%). Additionally, 83% of the patients when interviewed had a folk history of tuberculosis. Keywords: Microscopy, PCR, Mycobacterium tuberculosis, Rifampicin.