Prevalence and Resistance Profiles of Drug-resistant Tuberculosis in the Southeastern Region of Nigeria
Ogechukwu Yvonne Ozoadibe
Laboratory Department, Niger Foundation Hospital and Diagnostic Centre, Enugu, Nigeria andWater and Public Health Research Group, Department of Microbiology, University of Nigeria, Nsukka, Nigeria.
Marie-Esther Uju Dibua
Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Nigeria.
Clara Idara Eleazar
Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Nigeria.
Johnson Chijindu Diara
Department of Public Health, David Umahi Federal University, Uburu, Ebonyi State, Nigeria.
Vincent Nnamdigadi Chigor *
Water and Public Health Research Group, Department of Microbiology, University of Nigeria, Nsukka, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background and Aims: Drug-resistant tuberculosis (DR-TB) complicates tuberculosis control and requires accurate characterisation of resistance patterns to guide clinical and public health responses. This study investigated the prevalence and pattern of DR-TB among presumptive and follow-up tuberculosis patients in southeastern Nigeria.
Study Design: A cross-sectional, multicentre regional epidemiological survey was employed.
Place and Duration of the Study: The study was conducted across secondary and tertiary referral health facilities in Abia, Anambra, Ebonyi, Enugu, and Imo States, southeastern Nigeria, between January 2020 and December 2021.
Methodology: Sputum specimens were collected from 217 presumptive and follow-up pulmonary tuberculosis (PTB) patients, comprising 144 males and 73 females. Sociodemographic data and clinical history were collected using structured clinical request forms (NTBLCP-02). Samples were screened using the GeneXpert MTB/RIF assay to detect Mycobacterium tuberculosis complex and rifampicin resistance (RR). All samples were thereafter subcultured on Lowenstein-Jensen media and subjected to line probe assay (LPA). Data were analysed using IBM SPSS version 27.
Results: The prevalence of drug-susceptible TB was 14.3%, while mono-resistance to either rifampicin or isoniazid was 41.9%. Multidrug-resistant TB (MDR-TB) was detected in 36.4% of isolates, Pre-XDR TB in 4.1%, and XDR-TB in 3.2%. The resistance rates to rifampicin and isoniazid (first-line drugs) were 82.5% and 41.0%, respectively. The resistance rates to fluoroquinolones and aminoglycosides (second-line drugs) were 6.5% and 4.1%, respectively. There was no significant difference in the distribution of mono- and multidrug resistance across the states (p = .873).
Conclusion: Drug-resistant tuberculosis presents a substantial public health threat in southeastern Nigeria, driven primarily by previous treatment exposure and incomplete regimen adherence. Expanding access to universal rapid molecular drug-susceptibility testing (DST) and second-line susceptibility testing is critical for curbing ongoing transmission and guiding targeted therapeutic strategies in the region.
Keywords: Drug-resistant, tuberculosis, prevalence, resistant profiles, rifampicin resistance, isoniazid resistance, southeastern Nigeria