Genetic Assay and Drug Resistance Profile of Mycobacterium tuberculosis Complex among Tuberculosis Patients from Selected Hospitals in Benue and Nasarawa State, Nigeria

Abstract

Molecular detection of drug resistance was performed using the Line Probe Assay (LPA) with Hain Lifescience Genotype MTBDRplus and MTBDRsl kits, targeting mutations in the rpoB, katG, inhA, gyrA, gyrB, rrs, and eis genes. Analysis of rifampicin resistance (rpoB) showed that 94 out of 150 samples (62.7%) retained all wild-type (WT) codons, indicating susceptibility to rifampicin. Furthermore, 104 samples (69.3%) showed all WT codons for isoniazid, while 46 samples (30.7%) indicated resistance due to missing WT codons. For fluoroquinolone (FQs) resistance, 45 out of 68 samples (66.2%) exhibited all WT codons in the gyrA gene, suggesting susceptibility, and 67.6% of samples for the gyrB gene also maintained WT codons, indicating similar susceptibility. The rrs gene analysis for low-level kanamycin resistance revealed that 49 samples (72.1%) maintained all WT codons, suggesting susceptibility, while 16.2% and 11.8% of samples showed missing WT codons, indicating possible resistance. To assess the relationship between infection and various demographic, clinical, and risk factors, chi-square analysis was employed. These findings are consistent with global reports estimating around 400,000 MDR/RR-TB cases in 2023,   with Nigeria accounting for 4.6% of the global TB burden. This situation emphasizes the urgent need for targeted diagnostic interventions within the country. This study highlights the critical role of molecular diagnostic tools in the early detection of drug-resistant TB. Rapid assays like GenoType MTBDRplus/sl not only facilitate timely clinical interventions but also enhance patient management, effectively reducing both transmission and mortality rates. The broader application of such diagnostic methods within Nigeria’s TB control framework is essential for achieving the WHO End TB Strategy targets.