PREVALENCE AND DETERMINANTS OF RIFAMPICIN RESISTANT TUBERCULOSIS AMONG PATIENTS ATTENDING NATIONAL TUBERCULOSIS AND LEPROSY TRAINING CENTER, SAYE, ZARIA, KADUNA STATE, NIGERIA
Tuberculosis (TB) remains a global health challenge, with Nigeria ranking among the high-burden countries for TB and drug-resistant TB. Rifampicin-resistant TB (RR-TB) poses a significant threat to TB control, given its association with poor outcomes, prolonged treatment, and increased transmission. This study determined the prevalence of Mycobacterium tuberculosis (MTB) and the determinants of rifampicin resistance among patients attending the National Tuberculosis and Leprosy Training Center, Saye, Zaria. A cross-sectional study was conducted among 423 presumptive TB patients, with sputum samples analyzed using the GeneXpert MTB/RIF assay. Sociodemographic, clinical, and behavioral information was obtained through structured questionnaires. To identify determinants of rifampicin resistance, chi-square tests were employed for preliminary associations, and logistic regression was applied to determine significant predictors. Due to the limited number of rifampicin-resistant cases (n=5), a nested case–control design was adopted, in which each case was matched with five rifampicin-sensitive controls (1:5 ratio). This strategy optimized statistical power and the precision of estimates without substantially increasing study costs, consistent with established epidemiological recommendations. The mean age of participants was 36.6 years (SD ±18.4), with the 25–34-year age group most represented (22.7%). The prevalence of MTB detected was 14.2%. Chi-square analysis showed significant associations between rifampicin resistance and multiple pulmonary TB episodes (p=0.003), HIV co-infection (p=0.041), exposure to an MDR-TB patient (p=0.023), treatment interruption (p<0.001), poor adherence (p=0.009), and adverse treatment outcomes (p=0.009). Logistic regression confirmed single PTB episode (AOR: 4.96; 95% CI: 1.02–5.82; p=0.010), HIV infection (AOR: 2.39; 95% CI: 1.27–95.18; p=0.029), reported regular medication use (AOR: 6.06; 95% CI: 1.00–4.07; p=0.009), and treatment success (AOR: 5.38; 95% CI: 1.01–6.96; p=0.025) as predictors of rifampicin resistance. The detection of MTB in 14.2% of the study population underscores ongoing community transmission. Rifampicin resistance was strongly influenced by HIV co-infection, prior TB episodes, and treatment-related factors, highlighting both acquired and primary transmission. Strengthening diagnostic coverage, adherence support, and integration of TB/HIV services is essential to curb the spread of drug-resistant TB in Nigeria.
Keywords: Bacterial, Drug Resistance, Nigeria, Pulmonary, Rifampin, Tuberculosis
*Correspondence: adoumar2014@gmail.com, 08032862715
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