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

Chinenye Esther Okoro-Ani; Confort Nnenna Akujobi; Iniekong Philip Udoh; Stellamaris Ojiuzor Ibhawaegbele; Charles Ikechukwu Ezema; Uchechukwu Anthonia Ezeugwu; Ogechukwu Calista Dozie-Nwakile; Aaron Chukwuemeka Okpe

doi:doi:10.11648/j.cbe.20210601.11

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

Chinenye Esther Okoro-Ani, Confort Nnenna Akujobi, Iniekong Philip Udoh, Stellamaris Ojiuzor Ibhawaegbele, Charles Ikechukwu Ezema, Uchechukwu Anthonia Ezeugwu, Ogechukwu Calista Dozie-Nwakile, Aaron Chukwuemeka Okpe

Published in Chemical and Biomolecular Engineering (Volume 6, Issue 1)

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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ACS 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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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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TY  - JOUR
T1  - Resistance Rate Distribution of MDR-TB Among Pulmonary Tuberculosis Patients Attending NAUTH and St Patrick’s Hospital Mile 4 Abakiliki in Southeast Nigeria
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
Y1  - 2021/03/22
PY  - 2021
N1  - https://doi.org/10.11648/j.cbe.20210601.11
DO  - 10.11648/j.cbe.20210601.11
T2  - Chemical and Biomolecular Engineering
JF  - Chemical and Biomolecular Engineering
JO  - Chemical and Biomolecular Engineering
SP  - 1
EP  - 10
PB  - Science Publishing Group
SN  - 2578-8884
UR  - https://doi.org/10.11648/j.cbe.20210601.11
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

Chinenye Esther Okoro-Ani

Department of Medical Microbiology, Medical Laboratory Services, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria
Confort Nnenna Akujobi

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

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

Department of Medical Laboratory Science, Ambrose Alli University, Ekpoma, Nigeria
Charles Ikechukwu Ezema

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

Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
Ogechukwu Calista Dozie-Nwakile

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

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

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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

Copy | Download

@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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TY  - JOUR
T1  - Resistance Rate Distribution of MDR-TB Among Pulmonary Tuberculosis Patients Attending NAUTH and St Patrick’s Hospital Mile 4 Abakiliki in Southeast Nigeria
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
Y1  - 2021/03/22
PY  - 2021
N1  - https://doi.org/10.11648/j.cbe.20210601.11
DO  - 10.11648/j.cbe.20210601.11
T2  - Chemical and Biomolecular Engineering
JF  - Chemical and Biomolecular Engineering
JO  - Chemical and Biomolecular Engineering
SP  - 1
EP  - 10
PB  - Science Publishing Group
SN  - 2578-8884
UR  - https://doi.org/10.11648/j.cbe.20210601.11
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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