Rifampicin resistant tuberculosis in a secondary Health facility in Ilorin, Nigeria

Abstract

Background: Rifampicin resistant 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 Ilorin, Nigeria.

Method: One hundred and forty tuberculosis cases were referred to the chest clinic of Sobi Specialist Hospital, Ilorin from January to December, 2014. 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 83years. The mean age was 38.39± 13.75. There was male preponderance 84(60%), compared to 56(40%) female. The Sobi Specialist Hospital made the highest referral. The tertiary hospital, the University of Ilorin Teaching Hospital had no functional GeneXpert facility as at the time of this study. 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 statistically significant.

Conclusion: Our study highlights that physicians should have a 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 RIFresistance strains. There is need for increasing effort to interrupt the transmission of RIF-TB.

Keywords: Rifampicin resistant tuberculosis; Secondary health facility; Nigeria