Risk factors for rifampicin resistance tuberculosis among patients attending Directly Observed Treatments Centres in Southwestern Nigeria.

Abstract

Introduction: tuberculosis (TB) remains a disease of global health importance. GeneXpert has emerged as a useful tool for the diagnosis of drug resistant TB (DR-TB). We determined the risk factors associated with DR-TB among presumptive pulmonary TB patients.

Methods: a cross-sectional study was conducted among presumptive TB patients attending Directly Observed Treatments (DOTs) centres in Southwestern Nigeria. Sputum samples were obtained from individuals with suspected pulmonary TB, subjected to GeneXpert as the first-line test and then culture. Data were analysed using STATA 12.

Results: sputum samples were collected from 2,169 consecutive patients and processed. A greater proportion of the participants (52.14%) were female, most within the age range of 20-39 (38.36%) and 40-59 (36.93%) years. About two-thirds, 66.34% (1439/2169) were GeneXpert positive and of this, 47 (3.27%) were DR-TB. Overall, 44.04% (855/2169) samples were culture positive. 7.56% of the patients were HIV positive, while 19.50%, 1.52% and 61.96% were new, relapse and previously treated cases, respectively. Multivariate analysis identified case definition (OR=2.38; 95%CI: 1.92-3.03) and (OR= 8.33; 95%CI: 5.26-12.50) and HIV (OR= 1.85; 95%CI: 1.29-2.65) and (OR= 3.61; 95%CI: 2.59-5.02) based on GeneXpert and culture as important risk factors for TB and DR-TB infection among participants.

Conclusion: we found a moderate level prevalence of DR-TB with gender, previous TB treatments, and HIV status as major factors associated with DR-TB among study participants.