Rapid Molecular Detection of Mycobacterium Tuberculosis and Rifampicin Resistance among Suspected Tuberculosis Patients in Otukpo, Benue State Nigeria

Abstract

Pulmonary tuberculosis (PTB) is a common opportunistic infections (OI) inextricably bound to the Human Immuno-deficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS). This study was carried out to determine the prevalence of Mycobacterium tuberculosis and Human Immuno-deficiency Virus (MTB/HIV) co-infection and to evaluate the current level of Rifampicin (RIF) resistance in Otukpo local Government Area. Sputum samples were collected for the detection of Mycobacterium tuberculosis and rifampicin resistance using MTB/RIF geneXpert Analyzer. On spot screening was performed for HIV type 1 and type 2 (HIV1/2) following the Nigerian HIV serology algorithm. Blood samples were collected from positive cases for Cluster of Differentiation 4 (CD4+) estimation, White Blood Cells (WBC) count and Haemoglobin (HB) analysis respectively on a BD FACSCount (Becton Dickinson Fluorescence-Activated Cell Sorting count) analyzer and Sysmex analyzer. The project was carried out between December, 2014 and June, 2015 in a Centre for Integrated Health Program (CIHP) supported Anti-Retroviral Therapy and Directory Observing Treatment Short-course (ART/DOTS) clinic hosted by the General Hospital, Otukpo. MTB was detected in 62% (n=249/401) of the total samples analyzed. MTB/HIV co-infection was found in 31.1% (79/249) and RIF resistant cases was found in 13.2% (33/249). The age groups of 21-30 (25.7%) and 31-40 (31.7%) years had the highest number of MTB/HIV co-infection and RIF resistance respectively. Prevalence with respect to age distribution and MTB/HIV co-infection were not statistically significant with respect to gender (p>0.05 ). Also, RIF resistant cases were more in the re-treated cases 87.9% (29/33) than new cases 12.1% (4/33). Furthermore, there was a significant association between low CD4+count (64.6%) with MTB/HIV co-infection (p<0.05).White blood cell count of most participants with co-infection was within normal range (4.5-10 x 109/l). Similarly, 97.5 % (77/79) of co-infected persons had normal haemoglobin (8-17g/dl). MTB/HIV co-infection was most prevalent among farmers 62% (49/79), followed by commercial motor cyclist (Okada riders) 13.9% (11/79) and then students 5.1% (4/79). Creation of more Molecular Laboratories with rapid diagnostic capability is advocated to help understand the real burden of TB and Drug resistance pattern among TB patients living in Otukpo and her environ.