Characteristics of TB/HIV Co-Infection and Patterns of Multidrug-Resistance Tuberculosis in the Northwest Amhara, Ethiopia

Abstract

Background Multidrug-resistant tuberculosis (MDR-TB) has continued to be a serious public health threat and significantly challenges global TB control and prevention efforts, where the TB/HIV co-infection epidemic makes the situation much worse. The aim of the study was to determine the determinant factors associated with patterns of MDR-TB among pulmonary TB patients in the Northwest Amhara, Ethiopia. Methods A hospital-based cross-sectional study was conducted from May 2022 to February 2023 in the Northwest Amhara, Ethiopia. Data on the participants’ socio-demographics and clinical characteristics were obtained using a pre-tested checklist. Phenotypic susceptibility testing to first-line anti-TB drugs was performed on 180 isolates by automated BD BACTEC MGIT 960 system. Logistic regression analysis was performed to determine the association of risk factors with patterns of MDR-TB. A p-value ≤0.05 was considered statistically significant. Results The overall proportion of TB with HIV co-infected cases was 19.8% (50/252). Culture positivity was confirmed in 203/252 (80.6%) of sputum samples. Among 168 isolates, the DST showed that 119 (70.8%) isolates were pan-susceptible to all first-line drugs and prevalence of any resistance to first-line drugs was 49,168 (29.2%). Among the resistant isolates, 28 (16.7%) were any mono-resistance and 12 (7.1%) were determined to be resistant to MDR-TB. TB with a previous TB treatment (aOR = 6.73, 95% CI: 1.78–25.47, p = 0.005) and HIV co-infected (aOR = 0.252, 95% CI: 0.73–0.875, p = 0.03) were significantly associated with MDR-TB. Conclusion Higher prevalence of TB and MDR-TB was examined among TB patients in the study area. In the study, history of previous TB treatment was the strongest risk factor MDR-TB infection followed by TB with HIV co-infected cases. Therefore, there is a need of strengthening TB control and prevention programs to reduce the increase of TB incidence, further emergence and transmission of a public health threat of MDR-TB cases.

Mycobacterium tuberculosis and human immunodeficiency virus co-infection and associated variables among presumptive pulmonary tuberculosis patients in Ethiopia; a health institution based cross-sectional study

“…With this in mind, it was conducted on 314 presumptive PTB patients from the Metemma and Abrehajira hospitals located in northwest Ethiopia to investigate the MTB/HIV co-infection and associated variables. The current study's MTB/HIV co-infection rate was 35 %, which is comparable to numerous studies conducted across the globe, such as in Felege Hiwot & Debre Tabor hospitals, Ethiopia (41.9 %) [ 17 ]; Northeast Ethiopia (40.4 %) [ 9 ], Gambella, Southwest Ethiopia (35.5 %) [ 8 ], Kenya (41.8 %) [ 18 ], Ghana (30 %) [ 19 ]; Africa (31%–32 %) with Eastern Africa (31 %), Central Africa (41 %), Southern Africa (41 %), Western Africa (26 %) [ 3 , 4 ]; But, it is higher than the reports from northwest Ethiopia (19.8 %) [ 20 ]; (Ataye (7.89 %) [ 10 ]; and Addis Ababa, Ethiopia (4.5 %) [ 21 ]; Toga (23.7 %) [ 22 ]; and China (0.9 %) [ 23 ]. In contrast, a higher rate of MTB/HIV co-infection result was reported from PTB confirmed study conducted in South Africa (55.9 %) [ 24 ].…”

Insights into the in-vitro Susceptibility and Drug–Drug Interaction Profiles Against Drug-Resistant and Susceptible Mycobacterium tuberculosis Clinical Isolates in Amhara, Ethiopia

“…For the present study, among 168 phenotypic CCs MGIT 960 resulted isolates, a total of 32 stored clinical isolates of M. tuberculosis (20 resistant and 12 susceptible isolates) were used due to resource constraints. 22 A reference H37Rv drug-susceptible M. tuberculosis strain and molecular-grade water were used as positive and negative growth controls, respectively. The experiment was conducted at the University of Gondar Comprehensive Specialized Hospital (UoGCSH) TB culture laboratory.…”

Molecular characterization of genetic mutations with fitness loss in pulmonary tuberculosis patients associated with HIV co-infection in Northwest Amhara, Ethiopia

“…A total of 259 study participant sample sizes was calculated using a single population proportion formula, n = z 2 p (1 − p )/ d 2 in the previous study. 21 However, out of which, only 146 stored culture-positive clinical isolates of M. tuberculosis at the University of Gondar Comprehensive Specialized Hospital (UoGCSH) TB culture laboratory were used in the present study due to resource constraints. The clinical isolates were collected from GeneXpert-positive pulmonary TB patients with HIV co-infected and/or HIV-negative cases, drug-susceptible and/or drug-resistant TB, new and/or previously treated TB cases, etc.…”

“…Limited studies have taken into account that the prevalence of genetic variants likely varies by setting as defined somewhere 20 ; however, the association of HIV co-infection with the fitness cost of genetic variants is unknown. 21 The aim of the study was to assess the association between the drug resistance-conferring genetic mutations with fitness cost and TB/HIV co-infection as well as to determine the performance characteristics of a diagnostic MTBDRplus v2.0 test.…”