Molecular Detection of Multidrug Resistance Tuberculosis (MDR-TB) and Associated Risk-Factors among Smear-Positive Pulmonary Tuberculosis Patients in Jigjiga Town, Somali Region of Ethiopia

Molecular Detection of Multidrug Resistance Tuberculosis (MDR-TB) and Associated Risk-Factors among Smear-Positive Pulmonary Tuberculosis Patients in Jigjiga Town, Somali Region of Ethiopia

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Title: Molecular Detection of Multidrug Resistance Tuberculosis (MDR-TB) and Associated Risk-Factors among Smear-Positive Pulmonary Tuberculosis Patients in Jigjiga Town, Somali Region of Ethiopia
Author: Brhane, Mussie; Kebede, Dr. Ameha
Abstract: Drug resistant tuberculosis has emerged as a serious threat to global health. Molecular methods that target drug resistance mutations are suitable approaches for rapid drug susceptibility testing to detect drug resistance. The primary aim of this study was to investigate gene mutations associated with rifampicin and/or isoniazid resistance of Mycobacterium tuberculosis and to determine the associated risk factors related to drug resistant tuberculosis among smear-positive pulmonary tuberculosis patients attending Karamara General Hospital, located in Jigjiga Town. Institutional based cross sectional study design was employed. Sputum specimens were collected from 105 consecutive smear-positive pulmonary tuberculosis patients and decontaminated by1% N-acetyl L-cysteine NaOH method. Of the total specimens, 98 (93.3 %) gave interpretable results; in which 67 (68.4 %) were new cases and 31 (31.6 %) were previously treated cases. Among the patients, 58(59.2 %) were males. The mean and median age was 35 and 33 years, respectively. Of the 98 valid specimens, 80 (81.6%) were sensitive to both drugs and 18 (18.4%) were resistant to rifampicin and/or isoniazid. The prevalence of multidrug resistance tuberculosis in all, new and previously treated cases were 10/98 (10.2%), 3/67 (4.5%) and 7/31 (22.6%), respectively. While there was no mono-resistance to rifampicin, the prevalence of mono-resistance to isoniazid was 8 (8.2%).In the present study, previous treatment history of tuberculosis, close contact with tuberculosis patients and smoking cigarette were significantly associated with the development of drug resistance (P< 0.05).Mutations conferring resistance to rifampicin and isoniazid were detected in 18(18.2 %) and 10 (10.2 %) of the specimens, respectively. Among the total 10 rifampicin resistant specimens, the distribution of mutant genes in various regions showed that 8 (80%)had resulted because of absence of rpoB WT8 presence of rpoB MUT3 and the amino acids changed were Ser531Lue. Whereas, of the remaining two, 1 (10%) was due to the presence rpoB MUT2B and 1 (10%) in rpoB MUT2A. Of the total 18 isoniazid resistant specimens, 15 (83.3%) had mutations in the katG (codon 315) gene, indicating high level resistance, while 3 (14.7 %) of had mutations in the inhA promoter gene, indicating low level resistance. In the present study, relatively high prevalence of multidrug resistance-TB was observed in the study. This situation might threaten efforts of Tuberculosis control activities and further aggravate development of multidrug resistance tuberculosis. So the study underscores the importance of establishing advanced diagnostic facilities for early detection of multidrug resistance tuberculosis.
Description: 64p.
URI: http://hdl.handle.net/123456789/3262
Date: 2015-10


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