Rifampicin resistance patterns and dynamics of tuberculosis and drug-resistant tuberculosis in Enugu, South Eastern Nigeria

Introduction: Tuberculosis (TB) continues to be a public health problem globally. The burden is further exacerbated in developing countries like Nigeria, by poor diagnosis, management and treatment, as well as rapid emergence of drug-resistant TB. This study was conducted to evaluate the prevalence...

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Main Authors: Kenneth Okonkwo Ugwu, Ifeanyi Sunday Onah, Godwin Christopher Mbah, Ifeoma Maureen Ezeonu
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2020-09-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/12736
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author Kenneth Okonkwo Ugwu
Ifeanyi Sunday Onah
Godwin Christopher Mbah
Ifeoma Maureen Ezeonu
author_facet Kenneth Okonkwo Ugwu
Ifeanyi Sunday Onah
Godwin Christopher Mbah
Ifeoma Maureen Ezeonu
author_sort Kenneth Okonkwo Ugwu
collection DOAJ
description Introduction: Tuberculosis (TB) continues to be a public health problem globally. The burden is further exacerbated in developing countries like Nigeria, by poor diagnosis, management and treatment, as well as rapid emergence of drug-resistant TB. This study was conducted to evaluate the prevalence of drug-resistant TB, determine the rpoB gene mutation patterns of Mycobacterium tuberculosis (MTB) and model the dynamics of multidrug resistant TB (MDR-TB) in Enugu, Nigeria. Methodology: A total of 868 samples, from patients accessing DOTS services in designated centres within the zone, were screened by sputum-smear microscopy, while 207 samples were screened by Nucleic Acid Amplification (Xpert® MTB/Rif) Test (NAAT). A deterministic model was formulated to study the transmission dynamics of TB and MDR-TB, using live data generated through epidemiological study. Results: The results showed TB prevalence values of 22.1% and 21.3% by sputum-smear and NAAT assays, respectively. Analysis of the rifampicin resistance patterns showed the highest occurrence of mutations (50%) along codons 523 – 527. Factors such as combination therapy, multiple therapy and compliance to treatment had influence on both prevalence and development of TB drug resistance in the population. Conclusions: This first documentation of Rifampicin resistance patterns in MTB from Nigeria shows that a majority of rpoB gene mutations occurred along codons 523 to 527, contrary to the widely reported codon 531 mutation and that multiple interventions such as combination therapy, with good compliance to treatment are needed to reduce both prevalence and development of TB drug resistance in the population.
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spelling doaj-art-304c097ca31c4c6cb30666fb034e75722025-08-20T02:27:14ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802020-09-01140910.3855/jidc.12736Rifampicin resistance patterns and dynamics of tuberculosis and drug-resistant tuberculosis in Enugu, South Eastern NigeriaKenneth Okonkwo Ugwu0Ifeanyi Sunday Onah1Godwin Christopher Mbah2Ifeoma Maureen Ezeonu3Department of Microbiology, University of Nigeria, Nsukka, Enugu State, NigeriaDepartment of Mathematics, University of Nigeria, Nsukka, Enugu State, NigeriaDepartment of Mathematics, University of Nigeria, Nsukka, Enugu State, NigeriaDepartment of Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria Introduction: Tuberculosis (TB) continues to be a public health problem globally. The burden is further exacerbated in developing countries like Nigeria, by poor diagnosis, management and treatment, as well as rapid emergence of drug-resistant TB. This study was conducted to evaluate the prevalence of drug-resistant TB, determine the rpoB gene mutation patterns of Mycobacterium tuberculosis (MTB) and model the dynamics of multidrug resistant TB (MDR-TB) in Enugu, Nigeria. Methodology: A total of 868 samples, from patients accessing DOTS services in designated centres within the zone, were screened by sputum-smear microscopy, while 207 samples were screened by Nucleic Acid Amplification (Xpert® MTB/Rif) Test (NAAT). A deterministic model was formulated to study the transmission dynamics of TB and MDR-TB, using live data generated through epidemiological study. Results: The results showed TB prevalence values of 22.1% and 21.3% by sputum-smear and NAAT assays, respectively. Analysis of the rifampicin resistance patterns showed the highest occurrence of mutations (50%) along codons 523 – 527. Factors such as combination therapy, multiple therapy and compliance to treatment had influence on both prevalence and development of TB drug resistance in the population. Conclusions: This first documentation of Rifampicin resistance patterns in MTB from Nigeria shows that a majority of rpoB gene mutations occurred along codons 523 to 527, contrary to the widely reported codon 531 mutation and that multiple interventions such as combination therapy, with good compliance to treatment are needed to reduce both prevalence and development of TB drug resistance in the population. https://jidc.org/index.php/journal/article/view/12736M. tuberculosisNigeriarpoBXpert MTB/RIFnumerical simulation
spellingShingle Kenneth Okonkwo Ugwu
Ifeanyi Sunday Onah
Godwin Christopher Mbah
Ifeoma Maureen Ezeonu
Rifampicin resistance patterns and dynamics of tuberculosis and drug-resistant tuberculosis in Enugu, South Eastern Nigeria
Journal of Infection in Developing Countries
M. tuberculosis
Nigeria
rpoB
Xpert MTB/RIF
numerical simulation
title Rifampicin resistance patterns and dynamics of tuberculosis and drug-resistant tuberculosis in Enugu, South Eastern Nigeria
title_full Rifampicin resistance patterns and dynamics of tuberculosis and drug-resistant tuberculosis in Enugu, South Eastern Nigeria
title_fullStr Rifampicin resistance patterns and dynamics of tuberculosis and drug-resistant tuberculosis in Enugu, South Eastern Nigeria
title_full_unstemmed Rifampicin resistance patterns and dynamics of tuberculosis and drug-resistant tuberculosis in Enugu, South Eastern Nigeria
title_short Rifampicin resistance patterns and dynamics of tuberculosis and drug-resistant tuberculosis in Enugu, South Eastern Nigeria
title_sort rifampicin resistance patterns and dynamics of tuberculosis and drug resistant tuberculosis in enugu south eastern nigeria
topic M. tuberculosis
Nigeria
rpoB
Xpert MTB/RIF
numerical simulation
url https://jidc.org/index.php/journal/article/view/12736
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