Resistance to first‐line tuberculosis drugs in three cities of Nigeria
Objectives To determine the levels of resistance to first‐line tuberculosis drugs in three cities in three geopolitical zones in Nigeria.
Methods A total of 527 smear‐positive sputum samples from Abuja, Ibadan and Nnewi were cultured on BACTEC‐ MGIT 960. Drug susceptibility tests (DST) for streptomycin, isoniazid, rifampicin and ethambutol were performed on 428 culture‐positive samples on BACTEC‐MGIT960.
Results Eight per cent of the specimens cultured were multi‐drug‐resistant Mycobacterium tuberculosis (MDR‐TB) with varying levels of resistance to individual and multiple first–line drugs. MDR was strongly associated with previous treatment: 5% of new and 19% of previously treated patients had MDR‐TB (OR 4.1 (95% CI 1.9–8.8), P = 0.001) and with young adult age: 63% of patients with and 38% without MDR‐TB were 25–34 years old (P = 0.01). HIV status was documented in 71%. There was no association between MDR‐TB and HIV coinfection (P = 0.9) and gender (P > 0.2 for both).
Conclusions MDR‐TB is an emerging problem in Nigeria. Developing good quality drug susceptibility test facilities, routine monitoring of drug susceptibility and improved health systems for the delivery of and adherence to first‐ and second‐line treatment are imperative to solve this problem.
Document Type: Research Article
Affiliations: 1: Zankli Medical Centre, Abuja, Nigeria 2: Liverpool School of Tropical Medicine, Liverpool, UK 3: National Tuberculosis and Leprosy Control Programme, Abuja, Nigeria 4: Tropical Medicine Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia 5: University College Hospital, Ibadan, Nigeria 6: Wuse General Hospital, Abuja, Nigeria 7: Nnamdi Azikiwe Teaching Hospital, Nnewi, Nigeria
Publication date: 2011-08-01