Abstract
Tuberculosis (TB) incidence in Nigeria is high, with a significant burden of TB/Human Immunodeficiency Virus (HIV). Genotyping and drug susceptibility of Mycobacterium tuberculosis Complex (MTBC) are important in order to improve the control of the disease. This study sought to determine drug susceptibility and genetic diversity of MTBC in the country. The sputum samples of 202 patients [133 (65.8%) males/69 (34.2%) females] were collected in the North Central zone of Nigeria and cultured using Lowenstein–Jensen medium. Immunochromatography for the primary identification and Drug Susceptibility Testing (DST) by proportion method, as well as IS6110 typing, regions of difference 1, 4, 9, 12, 702, and 711, and spoligotyping were carried out on the isolates. Following the DST on 202 isolates, 51 (25.2%) showed resistance to at least one drug. Multidrug resistance was observed in 29/202 (14.4%) cases. HIV positivity [37/202 (18.3%) patients] was associated with rifampicin 9/37 (24.3%) resistance (p = 0.012) as well as gender (p = 0.009). Of the 202 isolates, 150 (74.3%) were identified as the Cameroon sublineage, followed by the UgandaI, Haarlem, and West Africa 1 with 18 (8.9%), 10 (5%), and 6 (3%), respectively. The LAM10_CAM was the most prevalent genetic family [128/202 (63.4%)], with the shared international type 61 [111 (55%) isolates] the largest cluster. Gender (p = 0.038) and age (p = 0.015) had significant associations with the LAM10_CAM family but neither with HIV (p = 0.479) nor drug resistance. Rifampicin resistance in TB/HIV coinfected patient is a major concern in the study area. The Mycobacterium africanum lineage showed a marked decrease, and the need to educate females most at risk of TB/HIV coinfection is advocated.
Highlights
The existence of Tuberculosis (TB) over the past millennia is not uncommon and outranks Human Immunodeficiency Virus (HIV) infection/acquired immunodeficiency syndrome among the 10 prominent deadliest infectious diseases worldwide
Dinic et al [37] recorded a significant increase in Multiple Drug Resistance (MDR)-TB including RIF (5.52%) in Lagos and Jos
It has been shown that the weakening of the immune system due to HIV infection increases the burden of TB with several outcomes such as the reactivation of latent TB and the emergence of resistant TB strains, such as the MDR-TB [38]
Summary
The existence of Tuberculosis (TB) over the past millennia is not uncommon and outranks Human Immunodeficiency Virus (HIV) infection/acquired immunodeficiency syndrome among the 10 prominent deadliest infectious diseases worldwide. The increasing trend toward globalization, transnational migration, inadequate treatment of active pulmonary TB, injudicious prescriptions among physicians accompanied by uninformed drug selection as well as default among patients exposing Mycobacterium tuberculosis (MTB) to sublethal doses for shorter durations are potential targets for outbreaks of drug resistant (DR) TB [2,3]. Nigeria ranks among the 30 countries with a significant burden of TB, TB/HIV, and DR-TB but among the 14 countries accounting for more than 64% of the estimated number of incident TB cases worldwide in 2017 [1]. There is a strong association of the genetic lineages with pathogenicity and resistance [9,10,11], and the genetic background of the MTBC can provide an insight in the understanding of its prevalence and transmission [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
