ANTI-TUBERCULOSIS DRUG RESISTANCE OF MYCOBACTERIUM TUBERCULOSIS COMPLEX AMONG SMEAR POSITIVE PATIENTS IN PARTS OF ABUJA AND KADUNA STATE, NIGERIA
ANTI-TUBERCULOSIS DRUG RESISTANCE OF MYCOBACTERIUM TUBERCULOSIS COMPLEX AMONG SMEAR POSITIVE PATIENTS IN PARTS OF ABUJA AND KADUNA STATE, NIGERIA
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Date
2021-02
Authors
IWAKUN, Mosunmula Oluwaseun
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Abstract
Tuberculosis (TB) caused by Mycobacterium tuberculosis has continued to be a major threat worldwide despite the existence of anti-tuberculosis drugs for the past 60 years. Nigeria ranks 7th among the 30 high tuberculosis burden countries and 2nd in Africa with an estimated incidence of 219 per 100,000 population and a case detection rate of 25% implying that transmission continues to occur within populations. This study was conducted to determine the Anti-tuberculosis Drug Resistance of Mycobacterium tuberculosis Complex (MTBC) among Smear Positive Patients in Parts of Abuja and Kaduna State, Nigeria. One hundred (100) Acid Fast Bacilli (AFB) smear positive sputum samples obtained from TB patients attending selected hospitals in Abuja and Kaduna State were processed for culture. The isolates were characterized using the Hain Line Probe Assay MTBC and CM kits. Drug resistance profile of the MTBC was determined using the Hain Line Probe Assay GenoType MTBDRplus kit. Questionnaire was used to obtain some demographics and risk factors predisposing to infection. Results obtained and data from the questionnaire were analysed using SPSS version 24 and chi-square analysis was used to determine relationship between TB and the parameters at 95% confidence interval. P-value less or equals to 0.05 was considered statistically significant. Results of the cultures from the 100 AFB smear positive sputum samples showed 86% (86/100) were culture positive, 9% (9/100) were culture negative and 5% (5/100) was contaminated. The prevalence of MTBC and Non tuberculous Mycobacteria (NTM) among culture positive patients was 93% (80/86) and 7% (6/86) respectively. Among the MTBC species, M. tuberculosis had the highest prevalence of 91% (73/80) while the lowest (3%: 2/80) was M. bovis. Among the Non tuberculous Mycobacteria (NTM) species isolated, M. fortuitum had the highest prevalence (50%: 3/6). Other NTMs isolated were M. mucogenicum, M. gordonae and M. intracellulare with same prevalence of 16.7% (1/6)
each. Pan-susceptible TB occurred with the highest (91.3%: 73/80) frequency among the MTBC isolates. About 8.8% (7/80) of the MTBC isolates were resistant to at least one of the two drugs (Rifampicin and Isoniazid) while only one (1.3%: 1/80) case was Multi- drug Resistant (MDR) TB with resistance to both Rifampicin (RIF) and Isoniazid (INH). The InhA gene conferring low level INH resistance occurred more (71.4%: 5/7) compared to the katG gene conferring high level INH resistance with a prevalence of (28.6%: 2/7) among the MTBC isolates. The only isolate that was MDR-TB had mutations at rpoB WT7 (526-529) and MUT3 (S531L) gene loci. Among the demographic and risk factors examined, none was significantly associated with drug resistant MTBC among the study population. Among the demographic and risk factors examined for NTM infection, there was statistically significant association between livestock farming and NTM infection in this study (P=0.0003). In view of the results obtained in this study, there is need for rapid screening of the drug resistance and speciation of Mycobacteria for prompt initiation of treatment.
Description
A THESIS SUBMITTED TO THE SCHOOL OF POSTGRADUATE STUDIES, AHMADU BELLO UNIVERSITY, ZARIA NIGERIA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OFTHE DOCTOR OF PHILOSOPHY IN MICROBIOLOGY
DEPARTMENT OF MICROBIOLOGY, FACULTY OF LIFE SCIENCES,
AHMADU BELLO UNIVERSITY, ZARIA, NIGERIA
Keywords
ANTI-TUBERCULOSIS DRUG RESISTANCE,, MYCOBACTERIUM TUBERCULOSIS COMPLEX,, SMEAR POSITIVE PATIENTS,, PARTS OF ABUJA,, KADUNA STATE, NIGERIA