Rifampicin resistance in mycobacterium tuberculosis patients using GeneXpert at Livingstone Central Hospital for the year 2015: a cross sectional explorative study

Abstract

BackgroundSince the recent introduction of GeneXepert for the detection of Tuberculosis (TB) drug resistance mutations in both primary resistance and acquired resistance in Zambia, little has been documented in literature on the issue of rifampicin resistance especially in the face of a high National TB burden. The study aimed to determine the prevalence of rifampicin resistance in tuberculosis patients at Livingstone Central Hospital for the year 2015.MethodsThis was a cross sectional study conducted at Livingstone Central Hospital where we reviewed 152 records (from January 1, 2015 to 31st December, 2015) involving patients who presented with clinically suspected TB or documented TB, whose samples were sent to the laboratory for GeneXpert Mycobacterium tuberculosis/rifampicin testing. Statistical evaluations used a one-sample test of proportion and Fisher’s exact test.ResultsThe age of participants ranged from 8 months to 73 years old (median = 34). Of the participants with complete data on gender, 99 (66%) and 52 (34%) were males and females respectively. The TB co-infection with HIV prevalence was 98.3% (p < 0.001). Prevalence of rifampicin resistance was 5.9% and there was no statistical significant difference between being male or female (p = 0.721).ConclusionWe were able to show from our study, evidence of rifampicin resistance at Livingstone Central Hospital. Hence, there was need for further in-depth research and appropriate interventions (i.e close follow-up and patient care for drug resistance positive patients).

Trends of Mycobacterium Tuberculosis and rifampicin resistance in Adigrat General Hospital, Eastern Zone of Tigrai, North Ethiopia

“…In this study, Mycobacterium tuberculosis was prevalent in all ages, but have seriously hit the age group of 30-44 years with 26.0% and of whom 34/420 (8.1%) were rifampicin resistant. The positivity nding was in line with studies conducted in Gondar (29.8%) [14], different studies in Ethiopia [21][22][23]35], WHO reports 2017 [2] and Agaro Teaching Health Center in southwestern Ethiopia [36].However, contrary ndings with several studies in a different part of Nigeria and Zambia [18,24,33] which had lower prevalence, but higher than a study conducted in eastern Uttar Pradesh (40%) [19].…”

“…According to our study, we found 132 (9.1%) of rifampicin-resistant cases among con rmed TB cases. This result is comparable with studies conducted in Debre Markos Referral Hospital (10.3%) [13], Felege Hiwot Referral Hospital and Debre Tabor Hospital (9.3%) [20], Addis Ababa (9.9 %) [48] and India (10.5%) [38].Our nds are higher than studies conducted on northwest, east and south parts of Ethiopia (2.9%-5.7%) [6,19,31-32,39,42,46 and 48], Nigeria (2.9%) [24] and Zambia (5.9%) [33].The possible explanation for these variations could be related to our retrospective approach spanning four years, or differences in study designs .However, our incidence was lower than for studies conducted in Gondar 15.8% [14],other parts of Ethiopia (11.5-39.4) [39-40and 51],Congo (42.2%) [47] and China (17.6-26.3%) [43 and 50].…”

“…However, our ndings were higher than studies conducted in the Debre Markos Referral Hospital (16.6%) [13], different studies across Ethiopia (20.3-24.2 %) [14,[29][30][31][32], and a WHO estimation for Ethiopia of 14% (9.6%-19%) [2]. Conversely, the ndings were lower than studies conducted in the Felege Hiwot Referral Hospital and Debre Tabor Hospital (41.9%) [20], Zambia (98.3%) [33], and South Africa (>70%) [34]. The possible explanations for this difference could be re ect policy recommendations for which HIV infected patients, as an eligible group, are more likely to be tested using GeneXpert™.…”

Trends of Mycobacterium Tuberculosis and Rifampicin resistance in Adigrat General Hospital, Eastern zone, Tigray Region, Northern Ethiopia

“…The positivity finding was in line with studies conducted in Gonder (29.8%) [14], different studies in Ethiopia [21][22][23]35], WHO reports 2017 [2] & Agaro Teaching Health Center in southwestern Ethiopia [36]. There are however contrary findings with several studies in a different part of Nigeria and Zambia [18,24,33] which had lower prevalence, but higher than a study conducted in eastern Uttar Pradesh (40%) [19].…”

“…However, our findings were higher than studies conducted in the Debre Markos Referral Hospital (16.6%) [13], different studies across Ethiopia (20.3-24.2 %) [14,[29][30][31][32], and a WHO estimation for Ethiopia of 14% (9.6%-19%) [2]. Conversely, the findings were lower than studies conducted in the FelegeHiwot Referral Hospital and Debre Tabor Hospital (41.9%) [20], Zambia (98.3%) [33] & South Africa (>70%) [34]. The possible explanations for this difference could be reflect policy recommendations for which HIV infected patients, as an eligible group, are more likely to be tested using GeneXpert™.…”