Prevalence of rifampicin-resistant tuberculosis and its associated factors in a tertiary health care center, South-west Nigeria.

Abstract

Background Tuberculosis is a chronic disease with associated high morbidity and mortality. In recent decades, there has been an increase in resistance to drugs used in treatment of tuberculosis. This is a major stumbling block in the global fight against tuberculosis. This study was to demonstrate the current prevalence of rifampicin-resistant tuberculosis and its associated predisposing factors in a Teaching Hospital in Nigeria.Methods This was a cross-sectional retrospective study involving 359 consecutive patients with bacteriologically confirmed tuberculosis seen between January 2015 and December 2019. Ethical approval was obtained from relevant authority. Drug susceptibility testing was performed for rifampicin using GeneXpert MTB/RIF assay. Relevant information was obtained from the clinical records of the patients with use of a well-structured proforma. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) version 23.0.Results There were a total of 359 patients out of which majority, 235 (65.5%) were males. The mean age was 39.78+16.31 (range 1 - 90 years). A larger percentage of the subjects were new cases of tuberculosis (n=312, 86.9%), 49(13.6%) were HIV positive. The overall prevalence of rifampicin resistance found was 2.5% (n=9/359). There was significant association between gender (p=0.005) and re-treatment (p=0.003). There was no significant association between rifampicin resistance and other factors including age and HIV.Conclusion Male gender and patients on re-treatment for tuberculosis are more at risk of developing resistance to rifampicin in our environment. There is a need to ensure compliance with all guidelines in the management of tuberculosis to prevent an increase in drug resistance.