Prevalence and Distribution of Non – Tuberculous Mycobacteria (NTM) Among MDR-TB Suspected Patients in Northern Malawi

Abstract

BackgroundNon-tuberculosis Mycobacteria (NTM) are increasingly being recognized as human pathogens, causing substantial morbidity and mortality in progressive lung disease, immunosuppressed, the elderly and the youth. Similarity of clinical symptoms with MTB, coupled with limited diagnostic capacities in tuberculosis (TB) endemic developing countries has led to misdiagnosis of NTM pulmonary disease. The study aimed at establishing the prevalence and distribution of NTM among Multi-Drug Resistance Tuberculosis (MDR-TB) suspected patients in Northern Region of Malawi based on laboratory culture records from 2015 to 2018 conducted at Mzuzu Central Hospital.MethodsThe study used a retrospective cross-sectional design. All culture positive underwent MTB confirmatory test using the SD-Bio line TB Ag MPT64 Kit to confirm MTB or to suspect for NTM. Data was analysed for descriptive statistics in SPSS version 20 and presented using frequency tables, charts and graphs.Results Out of 170 culture positive reports reviewed, 30 (18%) were NTM. Much as there were generally more males (69.4%) who were MDR-TB suspected patients, the proportion of NTM patients was female predominant 13/52 (25%) as compared to 17/118 (14%) for males while the age range of 30-49 was the most (22%) affected. Twenty-nine (97%) of the NTM cases were previously treated for MTB.ConclusionsThe high prevalence of NTM among MDR-TB suspected patients shows that the disease is a serious public health problem. This therefore calls for urgent attention from Ministry of Health and partners, health workers and all stakeholders involved in policy making so that NTM diagnosis should have a clear algorithm to avoid wastage a of resources as well as for good patient care.

Genetic Diversity of Non-Tuberculous Mycobacteria among Symptomatic TB negative Patients in Kenya

“…Sub-Saharan African countries have the greatest burden of TB infections [55]. Pulmonary TB infections compromise the structural integrity of the lungs subsequently providing a suitable niche for NTM adherence and multiplication, hence the high number of NTM observed in MDR-TB cases [56]. A co-infection of TB and NTM could also be a possible occurrence in MTB-DR cases where the presence of NTM is attributed to its failure to respond to the first-line anti-TB drugs [57].…”