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Resistance Rate Distribution of MDR-TB Among Pulmonary Tuberculosis Patients Attending NAUTH and St Patrick’s Hospital Mile 4 Abakiliki in Southeast Nigeria

Received: 28 August 2020    Accepted: 18 September 2020    Published: 22 March 2021
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Abstract

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. This study was designed to assess the resistance rate distribution of MDR-TB among pulmonary tuberculosis patients attending Nnamdi Azikiewe University Teaching Hospital (NAUTH) Nnewi and St Patrick’s Hospital Mile 4 Abakaliki in the Southeast Nigeria. 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). Xpert MTB/RIF assay detected MTB in 83 (80.6%) samples out of which 45 (67.2%) were rifampicin resistant. Sixty-seven (80.7%) of the isolates were resistant to at least one of the first-line drugs. Primary resistance was 91% while 19.4%, 35.8%, 22.4% and 22.4% of the isolates were resistant to one, two, three and four drugs respectively. Isoniazid had the highest rate of resistance (57.8%) while Ethambutol had the least (34.9%) and 30 (44.8%) of the resistant isolates were MDR. Smoking (P=.002), gender (P=.002) and history of TB treatment (P=.012) were significantly associated with drug resistance. Educational status was significantly associated with MDR-TB (P=.020). NAUTH and St Patrick’s hospital had MDR-TB rates of 38.9% and 46.9% respectively. The findings of this study indicate high prevalence of MDR-TB among patients with pulmonary TB in the study sites and this portrays a menace to adequate TB control. Prompt diagnosis of TB, adequate patient compliance to therapy and increased awareness and mass education is recommended.

Published in Chemical and Biomolecular Engineering (Volume 6, Issue 1)
DOI 10.11648/j.cbe.20210601.11
Page(s) 1-10
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Resistance, MDR-TB, Tuberculosis, Patient

References
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    Chinenye Esther Okoro-Ani, Confort Nnenna Akujobi, Iniekong Philip Udoh, Stellamaris Ojiuzor Ibhawaegbele, Charles Ikechukwu Ezema, et al. (2021). Resistance Rate Distribution of MDR-TB Among Pulmonary Tuberculosis Patients Attending NAUTH and St Patrick’s Hospital Mile 4 Abakiliki in Southeast Nigeria. Chemical and Biomolecular Engineering, 6(1), 1-10. https://doi.org/10.11648/j.cbe.20210601.11

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    Chinenye Esther Okoro-Ani; Confort Nnenna Akujobi; Iniekong Philip Udoh; Stellamaris Ojiuzor Ibhawaegbele; Charles Ikechukwu Ezema, et al. Resistance Rate Distribution of MDR-TB Among Pulmonary Tuberculosis Patients Attending NAUTH and St Patrick’s Hospital Mile 4 Abakiliki in Southeast Nigeria. Chem. Biomol. Eng. 2021, 6(1), 1-10. doi: 10.11648/j.cbe.20210601.11

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    AMA Style

    Chinenye Esther Okoro-Ani, Confort Nnenna Akujobi, Iniekong Philip Udoh, Stellamaris Ojiuzor Ibhawaegbele, Charles Ikechukwu Ezema, et al. Resistance Rate Distribution of MDR-TB Among Pulmonary Tuberculosis Patients Attending NAUTH and St Patrick’s Hospital Mile 4 Abakiliki in Southeast Nigeria. Chem Biomol Eng. 2021;6(1):1-10. doi: 10.11648/j.cbe.20210601.11

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  • @article{10.11648/j.cbe.20210601.11,
      author = {Chinenye Esther Okoro-Ani and Confort Nnenna Akujobi and Iniekong Philip Udoh and Stellamaris Ojiuzor Ibhawaegbele and Charles Ikechukwu Ezema and Uchechukwu Anthonia Ezeugwu and Ogechukwu Calista Dozie-Nwakile and Aaron Chukwuemeka Okpe},
      title = {Resistance Rate Distribution of MDR-TB Among Pulmonary Tuberculosis Patients Attending NAUTH and St Patrick’s Hospital Mile 4 Abakiliki in Southeast Nigeria},
      journal = {Chemical and Biomolecular Engineering},
      volume = {6},
      number = {1},
      pages = {1-10},
      doi = {10.11648/j.cbe.20210601.11},
      url = {https://doi.org/10.11648/j.cbe.20210601.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cbe.20210601.11},
      abstract = {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. This study was designed to assess the resistance rate distribution of MDR-TB among pulmonary tuberculosis patients attending Nnamdi Azikiewe University Teaching Hospital (NAUTH) Nnewi and St Patrick’s Hospital Mile 4 Abakaliki in the Southeast Nigeria. 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). Xpert MTB/RIF assay detected MTB in 83 (80.6%) samples out of which 45 (67.2%) were rifampicin resistant. Sixty-seven (80.7%) of the isolates were resistant to at least one of the first-line drugs. Primary resistance was 91% while 19.4%, 35.8%, 22.4% and 22.4% of the isolates were resistant to one, two, three and four drugs respectively. Isoniazid had the highest rate of resistance (57.8%) while Ethambutol had the least (34.9%) and 30 (44.8%) of the resistant isolates were MDR. Smoking (P=.002), gender (P=.002) and history of TB treatment (P=.012) were significantly associated with drug resistance. Educational status was significantly associated with MDR-TB (P=.020). NAUTH and St Patrick’s hospital had MDR-TB rates of 38.9% and 46.9% respectively. The findings of this study indicate high prevalence of MDR-TB among patients with pulmonary TB in the study sites and this portrays a menace to adequate TB control. Prompt diagnosis of TB, adequate patient compliance to therapy and increased awareness and mass education is recommended.},
     year = {2021}
    }
    

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    AU  - Chinenye Esther Okoro-Ani
    AU  - Confort Nnenna Akujobi
    AU  - Iniekong Philip Udoh
    AU  - Stellamaris Ojiuzor Ibhawaegbele
    AU  - Charles Ikechukwu Ezema
    AU  - Uchechukwu Anthonia Ezeugwu
    AU  - Ogechukwu Calista Dozie-Nwakile
    AU  - Aaron Chukwuemeka Okpe
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    DO  - 10.11648/j.cbe.20210601.11
    T2  - Chemical and Biomolecular Engineering
    JF  - Chemical and Biomolecular Engineering
    JO  - Chemical and Biomolecular Engineering
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    PB  - Science Publishing Group
    SN  - 2578-8884
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    AB  - 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. This study was designed to assess the resistance rate distribution of MDR-TB among pulmonary tuberculosis patients attending Nnamdi Azikiewe University Teaching Hospital (NAUTH) Nnewi and St Patrick’s Hospital Mile 4 Abakaliki in the Southeast Nigeria. 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). Xpert MTB/RIF assay detected MTB in 83 (80.6%) samples out of which 45 (67.2%) were rifampicin resistant. Sixty-seven (80.7%) of the isolates were resistant to at least one of the first-line drugs. Primary resistance was 91% while 19.4%, 35.8%, 22.4% and 22.4% of the isolates were resistant to one, two, three and four drugs respectively. Isoniazid had the highest rate of resistance (57.8%) while Ethambutol had the least (34.9%) and 30 (44.8%) of the resistant isolates were MDR. Smoking (P=.002), gender (P=.002) and history of TB treatment (P=.012) were significantly associated with drug resistance. Educational status was significantly associated with MDR-TB (P=.020). NAUTH and St Patrick’s hospital had MDR-TB rates of 38.9% and 46.9% respectively. The findings of this study indicate high prevalence of MDR-TB among patients with pulmonary TB in the study sites and this portrays a menace to adequate TB control. Prompt diagnosis of TB, adequate patient compliance to therapy and increased awareness and mass education is recommended.
    VL  - 6
    IS  - 1
    ER  - 

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Author Information
  • Department of Medical Microbiology, Medical Laboratory Services, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria

  • Department of Medical Microbiology and Parasitology, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University Awka, Nnewi Campus, Nnewi, Nigeria

  • Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria

  • Department of Medical Laboratory Science, Ambrose Alli University, Ekpoma, Nigeria

  • Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria

  • Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria

  • Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria

  • Department of Pharmacology/Therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria

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