Detection of Multi Drug Resistant Mycobacterium tuberculosis among Pulmonary Tuberculosis patients in Shendi city River Nile state–Sudan 2019

Abstract

Multi Drug resistant tuberculosis caused by Mycobacterium tuberculosis resisting to at least isoniazid and rifampicin and considered as a man-made phenomenon and detecting of such resistance at the earliest is essential to limit the spread of the evolving. This is a cross sectional and laboratory based study was conducted in Shendi , River Nile State ,Sudan during the period from July 2019 to December 2019, aimed to determining the frequency of Multi Drug resistant among TB patients in Shendi to find the most risk factors associate with generating TB-resistance since using of special laboratory tests a fifty two samples from TB positive patients applied on Xpert MTB/RIF automated sample-processing and real-time PCR platform to detect M.tuberculosis and rifampicin resistance in a single-use-cartridge hands-free step ,The result showed from a fifty two patients referred to central laboratory and detected for RIF/ISO volunteered a distribution into ( 43 /52) ( 82.7 %) were active TB patients negative MDR compare with (9/52) (17.3%) were MDR TB patients.17.3% (9/ 52) positive for MDR-TB, And when it comes to risk factors the people who live in rural was most frequent (100%) MDR positive than who live in urban area (0%) And 6 patients with HIV co infection was positive MDR-TB (67%) patient and 2 patient (22%) was negative for MDR-TB and patient with previous treatment found positive for MDR-TB 8 (89%) from total 9 MDR-TB. There was a significant association between MDR-TB and previous treatment also significant association between MDR-TB and Geographic area also negative relation with HIV co infection while there was no significant association between MDR-TB and gender of patients, occupation, level of education and Mycobacterium tuberculosis quantity and age.

In conclusion this frequency is considered obstacle for TB control program so detection of resistance and adequate treatment is crucial. And MDR-TB mostly prevalent in rural area due to lack of health services and/or difficulties in accessing to health services