article · PLoS ONE
A retrospective multicentre study investigated the prevalence of Mycobacterium tuberculosis and rifampicin-resistant strains among adults suspected of having tuberculosis in Tigray, Northern Ethiopia. Analysing clinical records from six public hospitals between 2016 and 2019, the study reviewed diagnostic data from 30,300 patients tested with the Xpert-MTB/RIF assay. Tuberculosis was confirmed in 7.9 percent of presumptive cases. Among these positive individuals, 9.0 percent carried strains resistant to rifampicin, a critical first-line antibiotic. Infection rates were notably higher among individuals aged 18 to 29, people living with HIV, and patients who had previously undergone tuberculosis therapy. Drug resistance was especially prevalent among patients experiencing treatment failure or disease relapse. Although the overall frequency of tuberculosis among presumptive cases was relatively low, the high proportion of resistant strains underlines the need to improve treatment adherence and disease surveillance programmes.
Drug-resistant tuberculosis presents a severe challenge to public health, as standard frontline therapies become ineffective. Quantifying how frequently resistant bacteria occur helps health services understand the local burden of disease. Pinpointing high-risk populations, particularly individuals living with HIV and those with recurrent infections, enables healthcare programmes to focus diagnostic monitoring and tailored interventions where they are needed most.
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BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) continues to be a global health problem. Data on rifampicin resistance MTB using Xpert- MTB/RIF assay in Ethiopia, particularly in the study area is limited. The aim of this study was to determine the frequency of MTB and rifampicin resistant-MTB among presumptive tuberculosis patients in Tigray, Northern Ethiopia. METHODS: A multicenter retrospective study was conducted among presumptive TB patients from five governmental hospitals and one comprehensive specialized teaching hospital in Tigray regional state. Records of sputum sample results of presumptive MTB patients with Xpert-MTB/RIF assay from January 2016 to December 2019 were investigated. Data extraction tool was used to collect data from registration books and analyzed using SPSS ver.21 statistical software. Statistical significance was set at p-value ≤ 0.05. RESULTS: Of the 30,935 presumptive adult TB patients who have provided specimens for TB diagnosis from January 2016 to December 2019, 30,300 (98%) had complete data and were included in this study. More than half, 17,471 (57.7%) were males, and the age of the patients ranged from 18-112 years, with a median age of 40.65 (interquartile 29.4-56.5 years). Majority, 28,996 (95.7%) of the participants were treatment naïve, and 23,965 (79.1%) were with unknown HIV status. The overall frequency of MTB was 2,387 (7.9% (95% CI: 7.6-8.2%); of these, 215 (9% (95% CI: 7.9-10.2%) were rifampicin resistant-MTB. Age (18-29 years), HIV positive and previous TB treatment history were significantly associated with high MTB (p < 0.001), whereas gender (being female) was associated with low MTB (p < 0.001). Likewise, rifampicin resistant-MTB was more prevalent among relapse (p < 0.001) and failure cases (p = 0.025); while age group 30-39 years was significantly associated with lower frequency of rifampicin resistant-MTB (p = 0.008). CONCLUSION: Frequency of MTB among tuberculosis presumptive patients was low; however, the problem of rifampicin resistant-MTB among the tuberculosis confirmed patients was high. The high frequency of MTB and RR-MTB among previously treated and HIV positive patients highlights the need for more efforts in TB treatment and monitoring program in the study area.
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DOI: 10.1371/journal.pone.0240361
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