Assessment of Awareness of Anti-Tuberculosis Drug Resistance Among Tuberculosis Patients in a North-Central State of Nigeria
Authors: Muhammed Oyeniyi , Popoola Israel , Uthman Muhammed , Daniel Ebenezer , Popoola Taiwo , Bello Ahmed , Avwerhota Michael , Ogun Adebanke , Ekwuluo Celestine , Sam Samuel , Adejo Solomon , Tomori Michael , Ogundeji Adedamola , Adewole Jacob 
Published: February 2025

Tuberculosis (TB), a disease that remains preventable and curable, continues to represent a significant global health burden, particularly in regions like Nigeria. In this context, the emergence of drug-resistant strains of Mycobacterium tuberculosis poses an escalating challenge. This study aimed to assess awareness of anti-TB drug resistance among TB patients in Kwara State, Nigeria. Utilizing a descriptive cross-sectional design, data were gathered from 272 TB patients across six local government areas (LGAs) using a multi-stage sampling technique. Respondents were selected through a pre-tested, semi-structured questionnaire, targeting crucial socio-demographic factors, awareness levels, and other factors associated with drug resistance. Results revealed that 51.0% of the participants were male, and 64.5% lived in rural areas, with 43.3% having attained tertiary education. Alarmingly, over half of the respondents—62.8%—displayed poor awareness of anti-TB drug resistance, with only 4.1% demonstrating adequate knowledge of the concept. Additionally, merely 19.6% of the patients understood drug resistance, while only 6.5% were aware that multidrug-resistant TB (MDR-TB) is curable. These findings are concerning, especially since 10.2% of participants exhibited resistance to at least one first-line anti-TB drug, such as 2.9% to Isoniazid and 3.3% to Rifampicin. Furthermore, dual resistance to Rifampicin and Isoniazid was identified in 4.0% of respondents. Socio-demographic factors significantly affected TB prevalence, particularly among younger adults (40.8% of respondents were aged 30–39 years) and males (51.0%). However, there was no significant association found between resistance patterns and HIV status, as only 4.1% of respondents were HIV-positive. Contrastingly, behavioral factors such as alcohol consumption (17.1%) and history of close contact with TB patients (6.5%) were linked to increased drug resistance. Among those tested for second-line drug resistance, 4.1% displayed resistance, with specific cases involving combinations like Kanamycin and Protionamide. Notably, 27.8% had a history of incarceration, and 40% had been previously admitted to a hospital, both recognized as factors contributing to the spread of drug-resistant strains. Further analysis showed that only 10 (4.0%) of respondents experienced delayed treatment commencement, while 49.4% of participants reported never receiving any health talks or awareness about TB from their healthcare providers. Despite 86.9% of patients being informed about the lengthy treatment duration, there was a clear need for more comprehensive health communication. This study underscores the necessity for intensified public health interventions, emphasizing patient education, early diagnosis, and routine drug susceptibility testing prior to treatment initiation.