Abstract
This study was designed to determine the prevalence of multi-drug resistant tuberculosis (MDR-TB) among pulmonary tuberculosis patients attending NnamdiAzikiwe University Teaching Hospital (NAUTH) Nnewi and St Patrick’s Hospital Mile 4 Abakaliki demographically. Patients with persistent cough for over two weeks were screened by Ziehl-Neelsen ZN technique for the presence of acid fast bacilli (AFB) in their sputum and a total of 103 patients with AFB positive sputum samples were recruited. The positive sputum samples were subjected to Xpert MTB/RIF assay (GeneXpert®, Cepheid USA) and culture on Lowestein Jensen medium for 42 days at 37°C. Drug susceptibility testing was done on the isolates using the nitrate reduction assay (NRA). Eighty-three 83 (80.6%) of the isolates were obtained from culture after suspected colonies were subjected to morphological, biochemical, and immunological tests and out of the 83 (80.6%) samples analysed by Xpert MTB/RIF assay 45 (67.2%) were rifampicin resistant. Age group 26-35 years showed the highest proportion of positive culture results (33.7%) followed by age group 18-25 (28.8%) years. Demographically, age group 26-35 years had a high prevalence rate of MDR-TB (50.0%) and female gender also showed high prevalence rate of MDR-RB (48.5%). Strikingly, educational status was significantly associated with MDR-TB (P=.020). St Patrick’s hospital had a high prevalence rate of MDR-TB (46.94%) when compared with NAUTH (38.9%) and these indicates that there is high prevalence of MDR-TB among patients with pulmonary TB in these sites. The demographic results of this study calls for urgent and serious intervention as MDR-TB prevalence is increasing even in the face of intense national TB control program.
Highlights
Tuberculosis, one of the oldest recorded human afflictions, is still one of the biggest killers among the infectious diseases, despite the worldwide use of a live attenuated vaccine and several antibiotics
Of great concern is the fact that multi-drug resistant tuberculosis (MDR-TB) which is caused by Mycobacterium tuberculosis strains that do not respond to standard therapies poses problems for the treatment of individuals and for the control of TB in populations as it represents lapses in public health [4]
The result of this study showed high culture positivity rate demographically and this agrees with the report of [16] that stated 65.7% culture positivity rate in South-West Nigeria
Summary
Tuberculosis, one of the oldest recorded human afflictions, is still one of the biggest killers among the infectious diseases, despite the worldwide use of a live attenuated vaccine and several antibiotics. Of great concern is the fact that MDR-TB which is caused by Mycobacterium tuberculosis strains that do not respond to standard therapies poses problems for the treatment of individuals and for the control of TB in populations as it represents lapses in public health [4]. Studies both locally and globally have been done to assess the burden of MDR-TB within the population. This study assessed the demographic prevalence of MDR-TB among pulmonary tuberculosis patients attending Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi and St Patrick’s Hospital Mile 4 Abakaliki and the findings calls for urgent and serious intervention as MDR-TB prevalence is increasing even in the face of intense national TB control program
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