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Rifampicin Resistant Tuberculosis in a Secondary Health Institution in Nigeria, West Africa

Shittu O Rasaki*, Akanbi II A AJibola, Sanni A Musa, Alabi K Moradeyo, Odeigah LO, Sule G Abdullateef, Wale Adeoti and Isiaka-Lawal Salamat

Background: Rifampicin-dependent tuberculosis is an unrecognized and potentially serious treatment issue. Rifampicin resistance is a risk factor for poor outcome in tuberculosis. It is prevalent in Nigeria. Therefore, we sought to examine the pattern of rifampicin resistance tuberculosis in Nigeria, West Africa.

Method: One hundred and forty tuberculosis cases were referred to the chest clinic of Sobi Specialist Hospital from January to December 2013. Sputum samples were obtained from them, smeared on glass slides, stained using Ziehl Neelsen Stain and later observed under light microscopy. The GeneXpert MTB/RIF assay was used to simultaneously detect TB and rifampicin resistance.

Result: The minimum age of the patients was 18years, while the maximum was 83. The mean age was 38.39± 13.75. There was male preponderance 84(60%), compared to 56(40%) female. The secondary health institution made the highest referral. Forty eight (34.3%) had smear-positive TB, while 92(65.7%) were sputum negative. Thirty two (38.1%) male out of 84 and 12(21.4%) female out of 56 were sensitive to Rifampicin, while 6(7.1) male out of 84 and 4 (7.1%) female out of 56 were resistant to it. Forty four (31.4%) were MD-TB positive with a prevalence of 31.4%. Ten (7.2%) were Rifampicin resistant; this included 6 males and females. This was statically significant.

Conclusion: Our study highlights that physicians should have high index of suspicion for rifampicin resistant tuberculosis in patients refractory to anti-TB treatment. The MTB/RIF test is a useful method for rapid diagnosis of TB and detection of RIF-resistance strains. There is need for increasing effort to interrupt the transmission of RIF-TB.

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