Prevalence of Pulmonary Tuberculosis and Rifampicin Resistance Among Patients Attending Adama Hospital Medical College

TL;DR

This study found a high rate of pulmonary tuberculosis and some rifampicin resistance among patients in Ethiopia, with risk factors like contact with TB patients and smoking.

Contribution

The study provides new prevalence data on pulmonary TB and rifampicin resistance in eastern Ethiopia.

Findings

The prevalence of TB was 37.7% using ZN staining and 44.6% using GeneXpert.

2.1% of participants had rifampicin-resistant M. tuberculosis.

Contact with TB patients and smoking were significant risk factors for TB.

Abstract

Background: Tuberculosis (TB) is among the leading causes of morbidity and mortality in resource-limited countries. The burden of TB varies from country to country, depending on the country's condition and the effort made to prevent its transmission. The magnitude of pulmonary TB and drug resistance in eastern Ethiopia is mainly unknown due to limited information.

Objective: This study aimed to determine the prevalence of pulmonary TB and rifampicin-resistant Mycobacterium tuberculosis and factors associated with pulmonary TB.

Methods: A hospital-based prospective cross-sectional study was conducted among 424 presumptive TB patients who attended Adama Hospital Medical College from January 10, 2023, to November 10, 2023. Sputum (gastric lavage for children) was collected and diagnosed using the Ziehl–Neelsen (ZN) staining method and GeneXpert. A structured questionnaire was used to collect sociodemographic and clinical data. SPSS Version 20 computer software was used for data analysis. A variable with a p value less than 0.05 was considered statistically significant.

Results: The prevalence of the ZN staining method and GeneXpert-confirmed TB was 160 (37.7%), 95% CI: 33–42.7 and 189 (44.6%), 95% CI: 39.8–49.5, respectively. Of the study participants, nine (2.1%) were infected with rifampicin-resistant M. tuberculosis. Out of the 189 confirmed TB cases, 4.7% were infected with rifampicin-resistant gene-positive M. tuberculosis. Gender—male (AOR = 1.47 [0.95–2.26], p=0.081), history of contact with TB patient (AOR = 7.19 [2.55–20.25], p < 0.001), previously treated TB patients (AOR = 3.11 [1.49–6.50], p=0.003), and smoking cigarette (AOR = 14.8 [1.88–117], p=0.010) were significantly associated with GeneXpert-confirmed pulmonary TB.

Conclusion: The prevalence of pulmonary TB was high, with a moderate proportion of rifampicin-resistant gene-carrying M. tuberculosis in the study area. Being male, having a history of contact with TB patients, having a history of infection with TB, and smoking cigarettes were significant predictors of pulmonary TB.