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Hassanin ESA, Mohamed Hussein AA, Abdelrheem SS, Dongol E, Mhsb AHA, Zahran AM, Zein M, G Sayed I. Frequency of rifampicin-resistant mycobacterium tuberculosis by GeneXpert MTB/RIF assay and its correlates among 2605 probable tuberculosis patients in upper Egypt. Indian J Tuberc 2023; 70:345-355. [PMID: 37562911 DOI: 10.1016/j.ijtb.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/24/2022] [Accepted: 09/14/2022] [Indexed: 08/12/2023]
Abstract
RATIONALE GeneXpert MTB/RIF (Mycobacterium tuberculosis/rifampicin) assay is a method for detecting rifampicin resistance (RR-MTB) in suspected samples in less than 2 hours with high sensitivity and specificity yield. This study aimed to use the GeneXpert MTB/RIF assay to determine the frequency of RR-MTB and to study the possible influencing correlates associated with positive results. SUBJECTS AND METHODS This is a retrospective cross-sectional study of patients who visited TB clinic in 5 years (2016-2021). According to the data sheet of the patients, all the collected specimens were divided into 2 parts one for diagnosis by Ziehl-Neelsen stain and the other part for GeneXpert analysis. GeneXpert was also used to look for evidence of RR. RESULTS Out of the 2605 total samples screened, 718 (27.6%) tested positive for MTB on GeneXpert assay; of them 633 (88.4%) were sensitive to Rifampicin, 83 (11.6%) were resistant to Rifampicin and 2 cases were undetermined. Factors contributing to RR-MTB were: smoker/ex-smoker, with 2.5 times more risk (p = 0.013.0, p = 0.001); recurrence cases had a 4-fold increased risk (p < 0.001); patients with very low M. tuberculosis detected on the GeneXpert MTB/RIF test were 8 times more likely to have RR-TB (P = 0.004). CONCLUSION This study disclosed a high-rate MTB in Egyptian probable TB cases. Smoking, recurrence and cases with a very low M. tuberculosis burden noticed on the GeneXpert MTB/RIF test had augmented risk of RR-TB.
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Affiliation(s)
| | | | - Shaimaa S Abdelrheem
- Department of Public Health and Community Medicine, Faculty of Medicine, Aswan University, Egypt and Armed Forces College of Medicine (AFCM), Cairo, Egypt
| | | | | | - Asmaa M Zahran
- Clinical Pathology Department, South Egypt Cancer Institute Assiut University, Egypt
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Devrari JC, Chauhan M. Study the prevalence of rifampicin resistance among pulmonary tuberculosis patients by genexpert assay from a tertiary care hospital of North India. Int J Mycobacteriol 2023; 12:175-178. [PMID: 37338480 DOI: 10.4103/ijmy.ijmy_219_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Background Rifampicin (RIF) resistance (RR) tuberculosis (TB) has posed a great challenge to TB control programs globally. Evidence of RIF-RR can help as a surrogate marker to find out multidrug-resistance cases. The study aimed to determine the prevalence of RIF-RR in pulmonary TB (PTB) patients over the 4 years at Dr. RPGMC, Tanda, from the year 2018 to 2021. Methods This was a retrospective study conducted at Dr. RPGMC, Tanda at Kangra, where we checked (from January 2018 to December 2021) clinically suspected PTB patients, whose samples were sent to the laboratory for GeneXpert assay to identify Mycobacterium TB/RIF (MTB/RIF) testing. Results Of the total 11,774 clinically suspected PTB specimens were collected, and identified by GeneXpert MTB/RIF assay, in which 2358 samples were MTB positive and 9416 were MTB negative. Among 2358 MTB-positive samples, 2240 (95%) samples were RIF sensitive, in which 1553 (65.9%) were males and 687 (29.1%) were females, 76 (3.2%) samples were RIF-RR, in which 51 (2.2%) were males and 25 (1%) were females, and 42 (1.8%) samples were RIF indeterminate, in which 25 (1%) were males and 17 (0.8%) were females. Conclusion The rate of RIF-RR was found 3.2% of total samples which was more in males. The overall positivity rate was 20%, and the rate of positivity decreased from 32% to 14% over the 4 years in sputum samples. Hence, the GeneXpert assay was found to be very important tool to detect RIF-RR among suspected PTB patients.
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Affiliation(s)
- Jitendra Chandra Devrari
- Department of Microbiology, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - Madhu Chauhan
- Department of Microbiology, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
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Diriba G, Alemu A, Tola HH, Eshetu K, Yenew B, Amare M, Dagne B, Mollalign H, Sinshaw W, Abebaw Y, Seid G, Tadesse M, Zerihun B, Getu M, Moga S, Meaza A, Gamtesa DF, Tefera Z, Wondimu A, Hailu M, Buta B, Getahun M, Kebede A. Detection of Mycobacterium tuberculosis and rifampicin resistance by Xpert® MTB/RIF assay among presumptive tuberculosis patients in Addis Ababa, Ethiopia from 2014 to 2021. IJID REGIONS 2022; 5:97-103. [PMID: 36247095 PMCID: PMC9556786 DOI: 10.1016/j.ijregi.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 12/02/2022]
Abstract
Objective This study aimed to determine the frequencies and trends of Mycobacterium tuberculosis and rifampicin resistance among presumptive tuberculosis patients in Ethiopia, who were tested using the Xpert MTB/RIF assay between 2014 and 2021. Methods Data were collected retrospectively from patient registries. Laboratory-based data were extracted from the national tuberculosis (TB) referral laboratory database. All patients referred to the National Tuberculosis Reference Laboratory (NTRL) for TB diagnosis from all over the country between March 1, 2014 and September 30, 2021, and tested using the Xpert MTB/RIF assay, were included. The extracted data were entered into a Microsoft Excel sheet and analyzed by Statistical Package for Social Sciences (SPSS) version 23. Results Among a total of 13 772 individuals tested using the Xpert MTB/RIF assay, the majority (8223; 59.7%) were males, and 48.5% (6678) of the individuals were aged between 15 and 39 years. Mycobacterium tuberculosis (MTB) was detected in 17.0% (2347) of the examined individuals. Of the detected MTB cases, nearly 9.9% (233) were rifampicin resistant (RR-TB), while 24 (1.0%) were RR-intermediate. Among all RR-TB cases, more than half (125; 53.6%) were detected in males, and 105 were new TB cases. Extrapulmonary (EPTB) patients had a greater rate of rifampicin resistance (11.0%) than pulmonary (PTB) patients (9.6%). Conclusion The frequency of TB and RR-TB remains high in the study setting. RR-TB was found to have a statistically significant association with previous anti-TB medication treatment. As a result, improving treatment adherence in recognized instances could assist in preventing MTB and RR-TB cases.
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Key Words
- EPHI, Ethiopian Public Health Institute
- EPTB, extrapulmonary tuberculosis
- MDR, multidrug resistance
- MTB, Mycobacterium tuberculosis
- MTBC, Mycobacterium tuberculosis complex
- Mycobacterium tuberculosis
- NTRL, National Tuberculosis Reference Laboratory
- PTB, pulmonary tuberculosis
- RIF, rifampicin
- RR-TB, rifampicin-resistant tuberculosis
- SPSS, Statistical Package for Social Sciences
- TB, tuberculosis
- WHO, World Health Organization
- Xpert MTB/RIF
- frequency
- rifampicin resistance
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Affiliation(s)
- Getu Diriba
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ayinalem Alemu
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Habteyes Hailu Tola
- Department of Public Health, College of Health Sciences, Selale University, Fiche, Ethiopia
| | - Kirubel Eshetu
- USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia
| | - Bazezew Yenew
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Misikir Amare
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Biniyam Dagne
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Hilina Mollalign
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Waganeh Sinshaw
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yeshiwork Abebaw
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getachew Seid
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mengistu Tadesse
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Betselot Zerihun
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melak Getu
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Shewki Moga
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abyot Meaza
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dinka Fekadu Gamtesa
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zigba Tefera
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Amanuel Wondimu
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Michael Hailu
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Bedo Buta
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Muluwork Getahun
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abebaw Kebede
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
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Dutt R, Singh R, Majhi J, Basu G. Status of drug resistant tuberculosis among patients attending a tuberculosis unit of West Bengal: A record based cross-sectional study. J Family Med Prim Care 2022; 11:84-89. [PMID: 35309659 PMCID: PMC8930159 DOI: 10.4103/jfmpc.jfmpc_576_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/02/2022] Open
Abstract
Context: Tuberculosis (TB) is one of the main causes of death due to infectious diseases worldwide. Multidrug resistance/rifampicin resistance (MDR/RR) TB remains a public health crisis. India has the highest burden of tuberculosis and multidrug resistant TB (MDR TB) in the world. There is wide geographical variation in the epidemic and its trends that can be updated by regular reporting and sound surveillance systems. The current study tries to fill this gap by analyzing the data of TB patients from a Tuberculosis Unit, studying socio-demographic and clinical profile from December 2017 to November 2019 in Nadia district of West Bengal. Aims: The aims of this work were to study socio-demographic and clinical profile of TB patients attending Tuberculosis Unit of West Bengal, and to find out factors associated with drug-resistant TB. Settings and Design: Record-based study from Tuberculosis Unit. Methods: Records of all patients who undergo CBNAAT in TU are stored as monthly unit. We randomly selected 10 months from a period of December 2017 to November 2019 by using lot method. Data of all patients undergoing CBNAAT at Kalyani – Gayeshpur Tuberculosis Unit during randomly selected 10 months were accessed. Statistical Analysis Used: Monthly data was entered in Microsoft Excel and descriptive tests of significance, proportions and Chi-square were applied. Results: There was male preponderance for testing of tuberculosis. Seven percent of the TB suspects were HIV positive. The positivity rate of MTB by CBNAAT was 23%. Four percent of the samples were Rifampicin resistance. Tobacco consumption, contact with TB case and Diabetes were common risk factors of TB. Most of the information was missing in the records. Conclusions: Most of Rifampicin Resistant cases showed very low Ct value in CBNAAT. Previous history of TB treatment and positive HIV status was significantly associated with RR TB. There is a need to capture complete information on the records of presumptive TB cases.
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Abdullah SF. Sociodemographic profile of mono rifampicin-resistant (RR) cases among pulmonary tuberculosis patients, Erbil, Iraq, 2015–2020. MEDICAL JOURNAL OF BABYLON 2022. [DOI: 10.4103/mjbl.mjbl_75_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Andarge DB, Anticho TL, Jara GM, Ali MM. Prevalence of Mycobacterium tuberculosis infection and rifampicin resistance among presumptive tuberculosis cases visiting tuberculosis clinic of Adare General Hospital, Southern Ethiopia. SAGE Open Med 2021; 9:20503121211045541. [PMID: 34540228 PMCID: PMC8447093 DOI: 10.1177/20503121211045541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/24/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: Multidrug-resistant Mycobacterium tuberculosis is a public
health threat in resource-limited countries where it is easily disseminated
and difficult to control. The aim of this study was to determine the
prevalence of tuberculosis, rifampicin-resistant/multidrug-resistant
Mycobacterium tuberculosis, and associated factors
among presumptive tuberculosis cases attending the tuberculosis clinic of
Adare General Hospital located in Hawassa city. Methods: A hospital-based cross-sectional study was conducted among 321 tuberculosis
suspected patients from April to July 2018. Socio-demographic,
environmental, and behavioral data were collected using a structured
questionnaire. Sputum specimens were analyzed using GeneXpert. Data entry
was made using Epi info version 7 and analyzed by SPSS version 20. Logistic
regression models were used to determine the risk factors. A
p-value less than 0.05 was taken as a cut point. Results: In this study, the prevalence of Mycobacterium tuberculosis
was 98 (30.5%) with 95% confidence interval (25.5–35.8), and the prevalence
of rifampicin-resistant/multidrug-resistant Mycobacterium
tuberculosis among the 98 Mycobacterium
tuberculosis confirmed cases was 4 (4.1%). The prevalence of
rifampicin-resistant/multidrug-resistant Mycobacterium
tuberculosis among the tuberculosis suspected patients was
1.24%. Participants who had a history of treatment with anti-tuberculosis
drugs were more likely to develop rifampicin-resistant/multidrug-resistant
Mycobacterium tuberculosis. Conclusions: This study identified relatively high
rifampicin-resistant/multidrug-resistant Mycobacterium
tuberculosis among tuberculosis suspected patients in the study
area. Early detection of drug-resistant Mycobacterium
tuberculosis should be given enough attention to strengthen the
management of tuberculosis cases and improve direct observation therapy
short-course and eventually minimize the spread of rifampicin-resistant
tuberculosis strain in the community.
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Affiliation(s)
| | - Tariku Lambiyo Anticho
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Getamesay Mulatu Jara
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Musa Mohammed Ali
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Wasihun AG, Hailu GG, Dejene TA. Prevalence of Mycobacterium tuberculosis (Rifampicin-Resistant MTB) and Associated Risk Actors Among Pulmonary Presumptive TB Patients in Eastern Amhara, Ethiopia: 2015-2019. Infect Dis Ther 2021; 10:1299-1308. [PMID: 33950463 PMCID: PMC8322199 DOI: 10.1007/s40121-020-00368-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/24/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Tuberculosis (TB) is a major health problem, mainly in resource-limited settings. The aim of this study was to determine the prevalence of TB and rifampicin-resistant Mycobacterium tuberculosis (RR-MTB) among presumptive tuberculosis patients using Xpert MTB/RIF assay in Eastern Amhara, Ethiopia. METHODS A retrospective cross-sectional study was conducted among presumptive TB patients from three governmental hospitals in Amhara Regional State. Records of sputum sample results using Xpert MTB/RIF assay from January 2015 to December 2019 were investigated from registration books and analyzed using SPSS v.21. RESULTS Of the total of 26,656 (24,116 adults and 2540 children) TB presumptive patients included in the study, more than half, 14,624 (54.9%), were males and the median age was 36.87 (interquartile: 25.46-50.85 years). The majority of participants were new cases, 20,273 (76.1%), and with unknown HIV status, 18,981 (71.2%), respectively. MTB prevalence was 11% (95% CI: 9.34-12.08%) in all age groups, and 7.6% (95% CI 6.52-9.04%) among children. Of the MTB confirmed cases, prevalence of RR-MTB was 245 (8.3%) in adults and 14 (7.2%) in children. MTB infection was higher in the age groups of 18-35 years [adjusted odds ratio (AOR) = 2.17; 95% CI: 1.86-2.54, p < 0.001], 36-53 years (AOR = 1.31; 95% CI 1.11-1.54, p < 0.001), those who were relapse cases (AOR = 1.97; 95% CI 1.69-2.27, p < 0.0010), and failure cases (AOR = 4.67; 95% CI 3.36-6.50, p < 0.001). However, the age groups of 54-71 years (AOR = 0.79; 95% CI 0.65-0.95, p = 0.01) and over 71 years (AOR = 0.48; 95% CI 0.35-0.68, p < 0.001) were associated with lower MTB infection. Resistance to rifampicin was higher in the relapsed (AOR = 2.10; 95% CI 1.40-3.03, p < 0.001) and failure cases (AOR = 3.50; 95% CI 1.9-6.61, p < 001). CONCLUSION Prevalence of MTB and RR-MTB low. TB infection was higher in adult age groups and those who had previous TB treatment history. Similarly, resistance to rifampicin was higher among the relapsed and failure patients. Appropriate measurements in monitoring of TB treatment could reduce TB and RR-MTB in the study area.
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Affiliation(s)
- Araya Gebreyesus Wasihun
- Department of Medical Microbiology and Immunology, School of Medicine, Mekelle University, Mekelle, Ethiopia.
| | - Genet Gebrehiwet Hailu
- Department of Medical Microbiology and Immunology, School of Medicine, Mekelle University, Mekelle, Ethiopia
| | - Tsehaye Asmelash Dejene
- Department of Medical Microbiology and Immunology, School of Medicine, Mekelle University, Mekelle, Ethiopia.,Department of Medical Microbiology and Immunology, School of Medicine, Aksum University, Aksum, Ethiopia
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Danlami MB, Aliyu B, Samuel G. INCIDENCE OF RIFAMPICIN-RESISTANCE PRESUMPTIVE M. TUBERCULOSIS CASES AMONG OUTPATIENTS IN KEBBI STATE, NIGERIA. Afr J Infect Dis 2021; 15:47-52. [PMID: 33884358 PMCID: PMC8047284 DOI: 10.21010/ajid.v15i1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/20/2020] [Accepted: 09/23/2020] [Indexed: 11/23/2022] Open
Abstract
Background: The present study determined the incidence of rifampicin resistance M. tuberculosis among outpatients at the General Hospital Yauri, Kebbi State, Nigeria. Materials and Methods: The study is a cross-sectional study conducted from February 2018 to October 2019. Sociodemographic data were collected from hospital registration books. Rifampicin resistance M. tuberculosis was detected using GeneXpert Model GX-IV following manufacturers’ instruction. Descriptive statistics and logistic regression were computed using SPSS version 20. The results were presented as odds ratios with associated 95% confidence intervals, and P-value at 0.05. Result: Of the 837 samples, 65.8% (551/837) were males, and 34.2% (286/837) females, 11.4% (95/837) HIV-seropositive. M. tuberculosis was detected in 15.5% (130/837), of which 116/130 (89.23%) were males and 14/130 (10.77%) females. M. tuberculosis-HIV coinfection was detected in 9.47% (9/95) of HIV positive. Rifampicin resistance was observed in 1.3% (11/837), 7.7% (10/130) in M. tuberculosis patients and 1.05% (1/94) in HIV seropositive. In logistic regression, the odds ratio for having a rifampicin-resistant M. tuberculosis was 0.49 (0.15-1.54) for > 30 years; taking <30 years as the reference value, 1.02 (1.00-1.03) for male; taking female as the reference value, and 0.78 (0.09-6.15) for HIV positive, taking negative as the reference value. Conclusion: This study reported the current incidence rate of rifampicin-resistant M. tuberculosis at the General Hospital Yelwa Yauri, Kebbi State, Nigeria, among presumptive TB patients. Patients diagnosed with rifampicin-resistant M. tuberculosis were predominantly male adults. Thus, frequent screening is vital for surveillance and reduces the risk of transmission and spread of M. tuberculosis infections.
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Affiliation(s)
| | - Basiru Aliyu
- Department of Microbiology, Federal University Birnin Kebbi, PMB 1157 Kebbi State, Nigeria
| | - Grace Samuel
- Department of Microbiology, Faculty of Life Sciences, Kebbi State University of Science and Technology, Aliero, P.M.B. 1144. Birnin Kebbi, Kebbi State, Nigeria
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Wasihun AG, Dejene TA, Hailu GG. Frequency of MTB and rifampicin resistance MTB using Xpert-MTB/RIF assay among adult presumptive tuberculosis patients in Tigray, Northern Ethiopia: A cross sectional study. PLoS One 2020; 15:e0240361. [PMID: 33147218 PMCID: PMC7641410 DOI: 10.1371/journal.pone.0240361] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Multidrug-resistant tuberculosis (MDR-TB) continues to be a global health problem. Data on rifampicin resistance MTB using Xpert- MTB/RIF assay in Ethiopia, particularly in the study area is limited. The aim of this study was to determine the frequency of MTB and rifampicin resistant-MTB among presumptive tuberculosis patients in Tigray, Northern Ethiopia. METHODS A multicenter retrospective study was conducted among presumptive TB patients from five governmental hospitals and one comprehensive specialized teaching hospital in Tigray regional state. Records of sputum sample results of presumptive MTB patients with Xpert-MTB/RIF assay from January 2016 to December 2019 were investigated. Data extraction tool was used to collect data from registration books and analyzed using SPSS ver.21 statistical software. Statistical significance was set at p-value ≤ 0.05. RESULTS Of the 30,935 presumptive adult TB patients who have provided specimens for TB diagnosis from January 2016 to December 2019, 30,300 (98%) had complete data and were included in this study. More than half, 17,471 (57.7%) were males, and the age of the patients ranged from 18-112 years, with a median age of 40.65 (interquartile 29.4-56.5 years). Majority, 28,996 (95.7%) of the participants were treatment naïve, and 23,965 (79.1%) were with unknown HIV status. The overall frequency of MTB was 2,387 (7.9% (95% CI: 7.6-8.2%); of these, 215 (9% (95% CI: 7.9-10.2%) were rifampicin resistant-MTB. Age (18-29 years), HIV positive and previous TB treatment history were significantly associated with high MTB (p < 0.001), whereas gender (being female) was associated with low MTB (p < 0.001). Likewise, rifampicin resistant-MTB was more prevalent among relapse (p < 0.001) and failure cases (p = 0.025); while age group 30-39 years was significantly associated with lower frequency of rifampicin resistant-MTB (p = 0.008). CONCLUSION Frequency of MTB among tuberculosis presumptive patients was low; however, the problem of rifampicin resistant-MTB among the tuberculosis confirmed patients was high. The high frequency of MTB and RR-MTB among previously treated and HIV positive patients highlights the need for more efforts in TB treatment and monitoring program in the study area.
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Affiliation(s)
- Araya Gebreyesus Wasihun
- Department of Medical Microbiology and Immunology, School of Medicine, Mekelle University, Mekelle, Ethiopia
| | - Tsehaye Asmelash Dejene
- Department of Medical Microbiology and Immunology, School of Medicine, Mekelle University, Mekelle, Ethiopia.,Department of Medical Microbiology and Immunology, School of Medicine, Aksum University, Aksum, Ethiopia
| | - Genet Gebrehiwet Hailu
- Department of Medical Microbiology and Immunology, School of Medicine, Mekelle University, Mekelle, Ethiopia
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High Prevalence of Rifampicin Resistance Associated with Rural Residence and Very Low Bacillary Load among TB/HIV-Coinfected Patients at the National Tuberculosis Treatment Center in Uganda. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2508283. [PMID: 32775411 PMCID: PMC7397442 DOI: 10.1155/2020/2508283] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/30/2020] [Accepted: 07/14/2020] [Indexed: 01/05/2023]
Abstract
Background Rifampicin resistance (RR) is associated with mortality among tuberculosis (TB) patients coinfected with HIV. We compared the prevalence of RR among TB patients with and without HIV coinfection at the National Tuberculosis Treatment Center (NTTC) in Uganda, a TB/HIV high burdened country. We further determined associations of RR among TB/HIV-coinfected patients. Methods In this secondary analysis, we included adult (≥18 years) bacteriologically confirmed TB patients that were enrolled in a cross-sectional study at the NTTC in Uganda between August 2017 and March 2018. TB, RR, and bacillary load were confirmed by the Xpert® MTB/RIF assay in the primary study. A very low bacillary load was defined as a cycle threshold value of >28. We compared the prevalence of RR among TB patients with and without HIV coinfection using Pearson's chi-square test. We performed logistic regression analysis to determine associations of RR among TB/HIV-coinfected patients. Results Of the 303 patients, 182 (60.1%) were male, 111 (36.6%) had TB/HIV coinfection, and the median (interquartile range) age was 31 (25-39) years. RR was found among 58 (19.1%) patients. The prevalence of RR was 32.4% (36/111) (95% confidence interval (CI): 24-42) among TB/HIV-coinfected patients compared to 11.5% (22/192) (95% CI: 7–17) among HIV-negative TB patients (p < 0.001). Among TB/HIV-coinfected patients, those with RR were more likely to be rural residents (adjusted odds ratio (aOR): 5.24, 95% CI: 1.51–18.21, p = 0.009) and have a very low bacillary load (aOR: 13.52, 95% CI: 3.15–58.08, p < 0.001). Conclusion There was a high prevalence of RR among TB/HIV-coinfected patients. RR was associated with rural residence and having a very low bacillary load among TB/HIV-coinfected patients. The findings highlight a need for universal access to drug susceptibility testing among TB/HIV-coinfected patients, especially in rural settings.
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