Mycobacterium tuberculosis and HIV Co-infections among Patients Attending a Nigerian Tertiary Health Center

Abstract

Aim: The study is set to determine the prevalence of Mycobacterium tuberculosis and Drug Resistant-Mycobacterium tuberculosis in the HIV/AIDS endemic community. Methods: A three -year retrospective study was conducted from November, 2013 to November, 2016 in Benue State University Teaching Hospital, Makurdi Nigeria. The subject criteria included all patients above 15 years, suspected of pulmonary TB, treatment naïve (new) and re-treated cases irrespective of HIV status. The procedures involved Cepheid Gene Xpert MTB/Rif system, Ziehl Nelseen staining and HIV serologic testing. Results: In a total of two thousand nine-hundred and sixty-nine patients suspected of Mycobacterium tuberculosis, only 6.2% (N=183/2969) of patients was detected by Cepheid GeneXpert Mycobacterium/Rifampicin system, while Ziehl Nelseen staining alone detected 2.7% (N=83/2969) (X 2= 5.01; df=1; p=0.05). The age groups at risk were 21-35 years and 35-45 years with 54.6% and 27.4% respectively. Among the 183 patients, 12.0% (N=22/183) of patients were Rifampicin resistant. Seventy-seven per cent (N=17/22) of the Rifampicin Resistant Mycobacterium tuberculosis patients was for re treatment, while the remaining 23.0% (N= 5/22) was treatment naïve (X 2 =6.01; df=1; p<0.05). Seventy –one percent (N=130/183) of the patients detected with Mycobacterium tuberculosis were HIV sero-positive. All the Rifampicin Resistant Mycobacterium tuberculosis patients were HIV sero-positive. Among the Rifampicin sensitive patients; 68.3% (N=110/161) had HIV sero-positive status while 31.7% (N=51/161) was HIV sero-negative respectively. Conclusion: The prevalence of 6.2% Mycobacterium tuberculosis with 12.0% Rifampicin Resistance Mycobacterium tuberculosis in the study was remarkable in young adult male patients in re-treatment. A hundred per cent total population of Rifampicin Resistance Mycobacterium tuberculosis patients were HIV sero- positive. Therefore, we recommend proper education of the youth, especially in sexual habit and availability of a more robust rapid multi resistance TB drug diagnostic system in order to capture MDR TB and XDR TB across the country, while the HIV program continues.