Rifampicin resistance patterns and dynamics of tuberculosis and drug-resistant tuberculosis in Enugu, South Eastern Nigeria

Abstract

Introduction: Tuberculosis (TB) continues to be a public health problem globally. The burden is further exacerbated in developing countries like Nigeria, by poor diagnosis, management and treatment, as well as rapid emergence of drug-resistant TB. This study was conducted to evaluate the prevalence of drug-resistant TB, determine the rpoB gene mutation patterns of Mycobacterium tuberculosis (MTB) and model the dynamics of multidrug resistant TB (MDR-TB) in Enugu, Nigeria.
 Methodology: A total of 868 samples, from patients accessing DOTS services in designated centres within the zone, were screened by sputum-smear microscopy, while 207 samples were screened by Nucleic Acid Amplification (Xpert® MTB/Rif) Test (NAAT). A deterministic model was formulated to study the transmission dynamics of TB and MDR-TB, using live data generated through epidemiological study.
 Results: The results showed TB prevalence values of 22.1% and 21.3% by sputum-smear and NAAT assays, respectively. Analysis of the rifampicin resistance patterns showed the highest occurrence of mutations (50%) along codons 523 – 527. Factors such as combination therapy, multiple therapy and compliance to treatment had influence on both prevalence and development of TB drug resistance in the population.
 Conclusions: This first documentation of Rifampicin resistance patterns in MTB from Nigeria shows that a majority of rpoB gene mutations occurred along codons 523 to 527, contrary to the widely reported codon 531 mutation and that multiple interventions such as combination therapy, with good compliance to treatment are needed to reduce both prevalence and development of TB drug resistance in the population.

The Pattern of rpoB gene mutation ofMycobacterium tuberculosisand predictors of rifampicin resistance detected by gene Xpert MTB/Rif in Tanzania

“…The current study found that the most prevalent mutation in rpoB gene mutation in MTB was at probe E codon (529–533) (40.64%), followed by Probe D codon (523–529) 20.09% which was similar to studies done in Nigeria, Uganda, Pakistan, Addis Ababa Ethiopia, and Bangladesh (13–17), the similarities suggests that a significant number of low-income individuals migrating for shelters may be responsible for the spread of mutant strains within the community (18). Our findings differed from the study done in Northeast India and Enugu, South Eastern Nigeria, which revealed that the most prevalent mutations were detected at probes A and D, respectively (19,20). The differences might be attributed to geographical differences caused by the variations in the M. tuberculosis lineage (21).…”

Emerging Characteristic Profile of Patients on Multi-Drug Resistant Tuberculosis Treatment in Oyo State Drug-Resistant Tuberculosis Treatment Centres

“…The finding of this study shows that the mean age of the respondents is 35.71± 11.62 years, the overall prevalence of HIV among MDR-TB was 12.8% which is high compared to the national prevalence of 1.4% [8], this finding corroborates with the submission of Ugwu et al, [9]. They reported a prevalence rate of 16.7% in a similar study.…”

Comparative Studies of the Methods of Detecting Rifampicin Resistant Mycobacterium tuberculosis among Tuberculosis Patients Attending Aminu Kano Teaching Hospital, Kano

“…Measures to curtail the aggravating factors (such as poor diagnosis, management and treatment) to the TB infections should be put in emplace. Tuberculosis (TB) infections and the rapid emergence of drug-resistant TB remain public health concerns in developing countries and even the globe, Nigeria is not an exception to this (Ugwu et al, 2020).…”