Abstract
Objective: Drug resistant Mycobacterium tuberculosis is a public health threat globally. We described the drug resistance pattern of M. tuberculosis to first line anti-TB drugs and the prevalence of Multidrug resistant TB among TB patients at tertiary hospital Nnewi, Nigeria. Methods: Sputum specimens from 550 suspected TB patients were analyzed for AFB. The smear positive samples were subjected to culture and drug susceptibility testing to first line anti-TB drugs on Lowenstein-Jensen medium. Result: Out of 180 (32.7%) culture positive samples subjected to DST, 97 (53.8%) were susceptible to all first line anti-TB drugs while 83 (46.1%) were resistant to one or two anti- TB drugs. The level of resistance was significant at p<0.05 identifying three patterns, Mono-drug resistance in 34(18.8%) patients, Multi-drug resistance in 14 (7.7%) and Poly drug resistance in 35 (19.4%) patients. The proportion of TB cases with resistance to single drugs ranged from 5 (2.7%) for rifampicin to 12 (6.6%) for isoniazid and previously treated TB 8 (4.4%) patients was a significant factor (P<0.000) to development of MDR-TB compared to new TB patients 6(3.3%) within the age range of 21-40 years. Other factors such as age, gender and HIV positive status were not significantly associated with the development of any resistance. Conclusion: The investigation highlights the presence of drug resistant TB with high prevalence of MDR-TB in the studied community. Larger studies are urgently recommended to improve TB clinical management and control efforts.
Highlights
The emergence of M. tuberculosis (MTB) resistance to anti- TB drugs has been a major public health obstacle to achieve the goal of effective global TB control [1]
It is hope that the up-to date knowledge presented in this study will add to the understanding of the current drug resistant/Multidrug resistant TB (MDR-TB) situation in Nigeria and different countries of the world
Our findings showed that a national estimate was unable to capture local specific variations of MDR-TB in the country because they originated from sites where a programmed operational factor was high
Summary
The emergence of M. tuberculosis (MTB) resistance to anti- TB drugs has been a major public health obstacle to achieve the goal of effective global TB control [1]. World Health Organization reported that, the global resistance to any of the anti-TB drug accounted for 20% of all reported TB cases and estimated 500,000 multi-drug resistant TB (resistant to at least isoniazid and rifampicin) cases to emerge each year worldwide with 150,000 deaths from MDR-TB [3]. About 5.3% of all reported TB cases had MDR-TB, between 5-7% develop XDR-TB and globally only 10% with MDR-TB receive treatment leading more spread of MDR-TB which is difficult to treat [4]. The pandemic of HIV/AIDS have been attributed to upsurge of TB/MDR-TB globally and attack rate is heavy on the wage earning community in the age group of 15-49 years [3]. Migration of population has been reported to strengthen the transmission dynamics of TB as well as antimicrobial drug resistant organism
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