BACKGROUND AND AIMS: Drug-resistant tuberculosis (TB) poses a serious challenge to global control of TB. This multicentre study was to identify risk factors for drug resistance to the first line anti-TB drugs among TB patients presenting for care in three health facilities in Calabar, Nigeria. MATERIALS AND METHODS: A cohort of 100 consecutive TB patients were recruited. Demographic information such as age, sex, weight, height, occupation, previous TB diagnosis and treatment, smoking, alcohol dependence and substance abuse were obtained. Sputum samples were collected from participants and cultured on Lowenstein - Jensen (LJ) slopes. Drug susceptibility testing was then carried out for the isolates identified as Mycobacterium tuberculosis, using isoniazid, rifampicin, ethambutol and streptomycin. RESULTS: Forty-two of the 100 participants evaluated were found to be resistant to at least one drug. Multi-drug-resistant TB was seen in four persons. Statistically significant differences were found with respect to three variables: younger age, abandonment of TB treatment and presence of cavitary lesions on chest radiograph. The variables sex, alcohol dependence, tobacco use and previous imprisonment were not significantly associated with TB drug resistance. Four variables were significant following the multivariate analysis with the following adjusted odds ratios: abandonment of TB treatment (9.34), cavitary lesions on chest radiograph (5.88), younger age (6.25) and male sex (3.25). CONCLUSION: Thus, risk stratification of TB patients is advocated in clinical settings where diagnostic facilities for drug-resistant TB are scarce using the identified predictors. This group will benefit from close monitoring and early drug susceptibility testing.
BACKGROUND AND AIMS: Drug-resistant tuberculosis (TB) poses a serious challenge to global control of TB. This multicentre study was to identify risk factors for drug resistance to the first line anti-TB drugs among TB patients presenting for care in three health facilities in Calabar, Nigeria. MATERIALS AND METHODS: A cohort of 100 consecutive TB patients were recruited. Demographic information such as age, sex, weight, height, occupation, previous TB diagnosis and treatment, smoking, alcohol dependence and substance abuse were obtained. Sputum samples were collected from participants and cultured on Lowenstein - Jensen (LJ) slopes. Drug susceptibility testing was then carried out for the isolates identified as Mycobacterium tuberculosis, using isoniazid, rifampicin, ethambutol and streptomycin. RESULTS: Forty-two of the 100 participants evaluated were found to be resistant to at least one drug. Multi-drug-resistant TB was seen in four persons. Statistically significant differences were found with respect to three variables: younger age, abandonment of TB treatment and presence of cavitary lesions on chest radiograph. The variables sex, alcohol dependence, tobacco use and previous imprisonment were not significantly associated with TB drug resistance. Four variables were significant following the multivariate analysis with the following adjusted odds ratios: abandonment of TB treatment (9.34), cavitary lesions on chest radiograph (5.88), younger age (6.25) and male sex (3.25). CONCLUSION: Thus, risk stratification of TB patients is advocated in clinical settings where diagnostic facilities for drug-resistant TB are scarce using the identified predictors. This group will benefit from close monitoring and early drug susceptibility testing.
Authors: Florian Gehre; Jacob Otu; Lindsay Kendall; Audrey Forson; Awewura Kwara; Samuel Kudzawu; Aderemi O Kehinde; Oludele Adebiyi; Kayode Salako; Ignatius Baldeh; Aisha Jallow; Mamadou Jallow; Anoumou Dagnra; Kodjo Dissé; Essosimna A Kadanga; Emmanuel Oni Idigbe; Catherine Onubogu; Nneka Onyejepu; Aissatou Gaye-Diallo; Awa Ba-Diallo; Paulo Rabna; Morto Mane; Moumine Sanogo; Bassirou Diarra; Zingue Dezemon; Adama Sanou; Madikay Senghore; Brenda A Kwambana-Adams; Edward Demba; Tutty Faal-Jawara; Samrat Kumar; Leopold D Tientcheu; Adama Jallow; Samba Ceesay; Ifedayo Adetifa; Assan Jaye; Mark J Pallen; Umberto D'Alessandro; Beate Kampmann; Richard A Adegbola; Souleymane Mboup; Tumani Corrah; Bouke C de Jong; Martin Antonio Journal: BMC Med Date: 2016-11-03 Impact factor: 8.775