Prevalence of mycobacterium tuberculosis and its drug resistance pattern in different areas of Sindh, Pakistan

Abstract

<h3>Introduction</h3> According to the World Health Organization (WHO) about 2 billion people worldwide have been infected by <i>Mycobacterium tuberculosis</i> complex of which nearly 2 million people are dying annually. Rifampicin and isoniazid are the drugs commonly used for treatment, but their excessive use has led to the emergence of mutations in the genome of MTB. <h3>Methods</h3> A total of 380 pulmonary and extra pulmonary clinical specimens of patients were collected from different regions of Sindh, Pakistan. Samples were decontaminated using NALC-NaOH protocol followed by DNA extraction, and amplification of extracted MTB DNA was done by real time PCR. To check the drug resistant strains, hybridization of amplified products of positive samples were carried out by line probe assay. <h3>Results</h3> Prevalence of MTB infection in this study population was 11% and among females and males it was 10.14% and 12.13%, respectively. The highest positive ratio among different specimens was determined in pus (52%) and the first age group (1–20 years) was found most susceptible (13.5%). Among positive samples 33.3% were resistant to rifampicin and 23.3% were resistant to isoniazid and 6.6% samples were resistant to both the drugs. <h3>Conclusions</h3> Real-time assay is a rapid diagnostic tool. It can be applied to a wide range of clinical specimens including pus which might show negative AFB smear. In Pakistan prevalence and drug resistance of TB is on rise due to many socio-economical and other issues. Determination of drug resistance is important for effective treatment, particularly in our region where MDR and XDR TB are not very uncommon.