Non-tuberculous Mycobacteria Infection among People with HIV in Rivers State, Nigeria

Abstract

Background: The incidence of pulmonary non-tuberculous mycobacterial (NTM) disease is rapidly increasing in regions with high tuberculosis burden. The relative proportion of mycobacterial infections in HIV patients varies in different geographical areas, indicating the background frequency of latent Mycobacterium tuberculosis. Aim: An assessment of NTM infections among people living with HIV was carried out in Rivers State Nigeria. Methods: A sample of 260 people living with HIV presenting with symptoms suggestive of tuberculosis was recruited for the study.  Direct smears of the collected sputum samples were made on clean, grease-free slides, dried and stained by the Ziehl Neelsen (ZN) method to confirm sputum AFB positivity. The samples were cultured using the Lowenstein-Jensen media according to established protocols. Results: The results showed a 2.7% prevalence of NTM and a 61.2% prevalence of Mycobacterium tuberculosis infection. Logistic regression shows that factors associated with increased risk of NTM infection include; Age <40 (OR:2.7; 0.3 – 23.4), Persons with at most primary educational background (OR: 3.4; 0.7 – 15.9), Unemployment (OR: 0.5 – 12.4) and previous treatment for TB (OR: 2.4; 0.4 – 13.2). Conclusion: The study showed a considerable occurrence of NTM infection among persons suspected to have TB, hence there is a need to improve the spectrum of diagnosis for mycobacterial diseases in order to improve treatment outcomes and control the likely occurrence of drug resistant mycobacterial infections.