Prevalence and genetic determinant of drug-resistant tuberculosis among patients completing intensive phase of treatment in a Tertiary Referral Center in Nigeria

Int J Mycobacteriol. 2017 Jan-Mar;6(1):47-51. doi: 10.4103/2212-5531.201883.

Abstract

Background: Drug-resistant tuberculosis (DR-TB) continues to be a challenge in developing countries with poor resources. Despite the high prevalence of primary DR-TB, its routine screening prior to the treatment is not performed in public hospitals in Nigeria. Data regarding drug resistance and its genetic determinant among follow-up patients with TB are lacking in Nigeria. Hence, the aim of this study was to determine the prevalence and genetic determinant of drug resistance among the follow-up patients with TB in a tertiary hospital in Nigeria.

Materials and methods: This was a cross-sectional, laboratory-based study conducted on 384 sputum samples collected from consented follow-up patients with TB. Standard microbiology methods (Ziehl-Neelsen staining and microscopy) and polymerase chain reaction (PCR; line probe assay [LIPA]) were used to analyze the collected samples. Pearson's Chi-square test was used to analyze the generated data.

Results: Out of 384 sputum samples analyzed for Mycobacterium tuberculosis and DR-TB, 25 (6.5%) tested positive for acid-fast bacilli. These samples were subjected to PCR (LIPA), of which 18 (72%) tested positive for DR-TB. Of these 18 samples, mutations conferring resistance to rifampicin (rpoB) and isoniazid (katG and/or inhA) were detected in 12 (66.7%) and 6 (33.3%) samples, respectively. Transmission dynamics of DR-TB was not significantly (P > 0.05) dependent on demographic characteristics.

Conclusion: There is a need to strengthen the laboratory capacity for the diagnosis of TB and drug resistance testing and make these services available, affordable, and accessible to the patients who need them.

MeSH terms

  • Adult
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use*
  • Cross-Sectional Studies
  • DNA, Bacterial / genetics
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Female
  • Humans
  • Isoniazid / administration & dosage
  • Isoniazid / therapeutic use
  • Male
  • Microbial Sensitivity Tests
  • Molecular Diagnostic Techniques
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / genetics*
  • Mycobacterium tuberculosis / ultrastructure
  • Nigeria / epidemiology
  • Polymerase Chain Reaction
  • Prevalence
  • Rifampin / administration & dosage
  • Rifampin / therapeutic use
  • Sputum / microbiology
  • Tertiary Care Centers
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Tuberculosis, Multidrug-Resistant / microbiology*

Substances

  • Antitubercular Agents
  • DNA, Bacterial
  • Isoniazid
  • Rifampin