Baseline Evaluation of the Shorter Regimen for Multidrug Resistant Tuberculosis in South-South, Nigeria.

Abstract

Multidrug resistant Tuberculosis (MDR-TB) is a serious public health challenge and a security risk for childhood and adult life all over the world. The shorter regimen for multidrug resistant tuberculosis is a developmental stride to manage patients quickly and rapidly. The emergence of MDR-TB together with pre-extensively drug resistant tuberculosis had made treatment complicated for the patient and care givers. Selection of criteria from various studies was carried out by World Health Organization in 2016 which resulted to the
recommendation on the use of the shorter MDR-TB regimen under specific conditions.
However, the program was faced with challenges beginning with shortage in culture-based facilities and the Line Probe Assay which is not widely available. A total number of 168 sputum samples were collected and processed in a biosafety level 2 laboratory with level 3
practices in Port Harcourt. Sputum samples were decontaminated using sodium hydroxide citrate method. A random sampling technique was used to select samples for analysis at every stage. The aim of this study was to evaluate the baseline MDR-TB among patients seeking diagnostic services to be included in shorter regimen. There was a statistically significant proportion for males (46.67%) among age group 31-45 and age group 16-30 for females, (31.75%) (Fisher’s exact test p=0.02). There was also a statistically significant higher prevalence for Rifampicin resistance using Line Probe Assay compared to Culture (59.76% vs.40.24%; p=0.01). Resistance to fluoroquinolones was 3.5% in ages 16-30 and 31-45. Second line treatment failure co-infected with Non- Mycobacterium tuberculosis Complex (NMTBC) requires an urgent resolution. Pragmatic efforts are needed to stop the deadly MDR-TB and baseline investigation for second line anti TB drug resistance should be strengthened to sustain the shorter regimen program.