Magnitude of Mycobacterium tuberculosis, drug resistance pattern, and associated factors among patients referred to St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Creators: name: Kassa, Melkayehu
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2019

description: Background: Tuberculosis (TB) is an infectious disease caused by strains belonging to the Mycobacterium tuberculosis complex. Mycobacterium tuberculosis (M. tuberculosis) remains one of the most significant causes of death from an infectious agent and a major public health problem in the community. Drug development of drug resistance and its association with Human immunodeficiency virus (HIV) by far the major cause of the current increase in tuberculosis infection. Sub-Saharan Africa is endemic for both TB and HIV infection, and pulmonary tuberculosis (PTB) in the HIV-affected countries of eastern and southern Africa, such as Ethiopia, has increased rapidly in the past decades. Objective:-To assess the magnitude of Mycobacterium tuberculosis, drug-resistance pattern ,and associated factors among patients referred to St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted at SPHMMC, Addis Ababa, Ethiopia from Jan to July 2019. Socio-demographic data were collected by using structured questionnaire in face to face interview with patients. Sputum and non-sputum samples were also collected from 436 presumptive TB cases. All sputum specimens collected underwent digestion and decontamination using the NaOH-NALC method, whereas and extra pulmonary clinical samples were used directly without decontamination. After centrifugation sputum samples, the sediments were examined using Ziehl-Neelsen technique, analyzed with Gene X-pert MTB/RIF assay, and culture using Lowenstein-Jensen (LJ) and positive culture results were tested for drug resistance pattern using Line probe Assay (LPA). The collected data was entered to EPI info 2002 version 3.32 after data editing and cleaning, exported to SPSS version 23 for analysis. Results: The total of 436 respondents were included in the study, of this 223 (51%) were male. The mean ±SD age the participants was 38±17years. Regarding marital status, 238 (54.6%) participants were Julyried, and majority of the respondents 240(55%) urban resident, 214 (49 %) had monthly income 100-1000 Ethiopian Birr, 278 (63.8%) used carbohydrate as a usually monthly food item. Of the total, 374(85.8%) were diagnosed for pulmonary tuberculosis and 62(14.2%) were for extrapulmonary tuberculosis, and from all 130 (30-%) were HIV positive individuals. Out of the total participants, the overall LJ culture confirmed Mycobacterium tuberculosis was, 27 (6.2%), and three isolates were resistant for either INH or RIF drug, while two of them were MDR-TB based on line probe assays method. In a bivariate logistic regression analysis, having a previous TB-contact history (COR=3.1; 95 % CI: 1.1, 8.7; P=0.03), patient weight loss (COR=3.6; 95 % CI: 1.5-8.8; P=0.004), having pneumonia with chest X-ray diagnosis (COR=3; 95%CI:3, 33; P=0.02), and having CD4 + T-cells count 200-350/mm 3 of blood (COR=8.9; 95%CI:0.5, 0.9; p=0.049) were significantly associated. Conclusion: The magnitude of M. tuberculosis and MDR TB in this study highlights the need for further extended early case detection and managing MDR TB cases to minimize transmission and the suffering of patients.