Drug-resistance in chronic tuberculosis cases in Southern Nigeria

Abstract

Nigeria has a high burden of tuberculosis but the drug resistant situationwas previously unknown. This report evaluates the firstline drug resistance and associated factors among chronic tuberculosis cases from
the tuberculosis control programme in South south and South east zones ofNigeria. Descriptive study of chronic tuberculosis patients consecutively referred from March 2003 to December 2005. Information collected by indepth interview of patients and tuberculosis microscopy, culture and sensitivity of patients sputum. Of 82 patients infected with M. tuberculosis strains, 57(64.0%)weremaleswhile theirmean agewas 38.0 13.2 years. Fifty nine (72.0%) patients hadmultidrug-resistance tuberculosis with 35(42.7%) resistant to rifampicin, isoniazid, ethambutol, streptomycinwhile 14(17.1%) had poly-drug resistance and one patient had monoresistance to isoniazid. Within and outside the national control programme, drug therapy was inappropriate (69.5-81.7%) and treatment poorly supervised (26.8-39.0%). Factors associated with multidrug resistancewere amale age less than 45years andCategory 1 treatment in a private health facility. The multidrug resistance burden in chronic tuberculosis cases is very high in southern Nigeria and should be urgently and adequately controlled in the interest of public health.

Keywords: Multidrug-resistance tuberculosis, chronic, Mycobacterium tuberculosis, Nigeria.