Rifampicin-resistant <em>Mycobacterium tuberculosis</em> among tuberculosis-presumptive cases at University of Gondar Hospital, northwest Ethiopia

Abstract

BackgroundVarious studies have reported that the emergence of drug-resistant tuberculosis poses a significant threat to tuberculosis-control programs worldwide. Rifampicin resistance is a surrogate marker of multidrug-resistant tuberculosis, since it reveals the presence of greater than 90% isoniazid resistance. Evidence on rifampicin-resistant Mycobacterium tuberculosis is scarce in the literature.ObjectiveTo determine the prevalence of rifampicin-resistant M. tuberculosis among tuberculosis-presumptive cases at the University of Gondar Hospital.Materials and methodsA retrospective study was conducted at the University of Gondar Hospital from January 2013 to August 2015. Data were collected from registration books using a data-extraction format after securing ethical approval and checking the completeness of necessary information. Data were double-entered and rechecked to ensure accuracy and analyzed using SPSS version 20. Results were summarized using descriptive statistics. Associations were assessed using Fisher’s exact test, and P<0.05 was considered statistically significant.ResultsA total of 1,820 M. tuberculosis-presumptive patients were included in the study. The majority of the study participants were males (59.2%). The mean age of the participants was 36.6±15.8 years. The preponderant age-group was 24–30 years, with 477 (23.5%) patients. The overall prevalence of M. tuberculosis-confirmed cases was 448 (24.6%, 95% CI 0.23–0.27). Of the 448 M. tuberculosis-confirmed cases, 71 (15.8%, 95% CI 1.12–1.19) were resistant to rifampicin. Rifampicin-resistant M. tuberculosis was observed among HIV seropositives (14 [18.7%]), males (45[17.3%]), and previously treated tuberculosis patients (61 [16.5%]), although no significant association was found in this study.ConclusionThe overall prevalence of M. tuberculosis and rifampicin resistance was found to be high in tuberculosis patients in this study. Therefore, early detection of drug-resistant M. tuberculosis should be strengthened for management of tuberculosis patients.

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

“…In the present study, the overall forms of presumptive Mycobacterium tuberculosis positivity rate were 24.3%. Our nding was similar to studies conducted in the Debre Markos Hospital (23.2%) [13], Gondar Referral Hospital (24.6%) [14], Gambella (20.0%) [46], Afar (24.5%) [49], India (27.6%) [4], South Africa (26%) [15], Nigeria (22.9 %) [16] And the WHO report in Africa (25%) [2]. However, it was lower compared to reports in Jigjiga (65.5%) [17], Kenya (32.25%) [18], in eastern Uttar Pradesh (32.9%) [19] and Congo (79.1%) [47].The main difference in these latter ndings may show our inclusion of all forms of presumptive tuberculosis while other studies included identi ed cases of Mycobacterium tuberculosis.…”

“…This nding was supported by previous studies conducted in Amhara (27.7%) [26], Gambella [46], in Ethiopia (29.4%) [27], and in Central Nigeria (36.3%) [28]. 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].…”

“…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].…”

“…This nding was comparable to studies conducted in Afar (20.9) [49], Debre Markos Referral Hospital (15.1%) [13] and Gambella (19.6%) [46]. However, it is much lower than studies conducted in Felege Hiwot Referral Hospital and Debre Tabor Hospital (54.8) [20], Gondar (25.2 %) [14] and Zimbabwe (37.1%) [37].The discrepancies might be due to our inclusion of all presumptive TB cases, and a high number of participants.…”

“…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].…”