RESUMEN
Background: Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is one of the top infectious killer diseases in the world. The emergence of drug-resistant MTB strains has thrown challenges in controlling TB worldwide. This study investigated the prevalence of drug-resistant tuberculosis in the states of Nigeria and the risk factors that can increase the incidence of tuberculosis. Methods: The study is a cross-sectional epidemiological research carried out in the six senatorial districts of Ekiti and Ondo states, Nigeria, between February 2019 and January 2020. A structured questionnaire was administered to 1203 respondents for socio-demographic information, and sputum samples were collected from them for TB investigation. GeneXpert technique was used to diagnose TB from the sputum samples, followed by bacterial isolation using Löweinstein-Jensen medium and antibiotic susceptibility testing. Results: Prevalence of TB in the two states combined was 15 â%; with 13.8 â% for Ekiti state and 16.1 â% for Ondo State. The distribution of TB in the senatorial districts was such that: Ondo South â> âEkiti Central â> âEkiti South â> âOndo North â> âEkiti North â> âOndo Central. The risk factors identified for TB prevalence in two states were gender, male â> âfemale (OR â= â0.548, p â= â0.004); overcrowding (OR â= â0.733, p â= â0.026); room size (OR â= â0.580, p â= â0.002); smoking (OR â= â0.682, p â= â0.019) and dry and dusty season (OR â= â0.468, p â= â0.005). The prevalence of MDR-TB in Ekiti and Ondo States were 1.2 â% and 1.3 â% respectively. The identified risk factors for MDR were education (OR â= â0.739, p â= â0.017), age (OR â= â0.846, p â= â0.048), religion (OR â= â1.95, p â= â0.0003), family income (OR â= â1.76, p â= â0.008), previous TB treatment (OR â= â3.64, p â= â0.004), smoking (OR â= â1.33, p â= â0.035) and HIV status (OR â= â1.85, p â= â0.006). Rifampicin monoresistant was reported in 6.7 â% of the rifampicin-resistant strains, while 93.3 â% were rifampicin polyresistant strains. Two (13.3 â%) of the MDR-TB strains were resistant to all the 3 first-line antimycobacterial agents. All the Rifampicin-resistant TB strains were susceptible to the aminoglycosides (Amikacin, Capreomycin and Kanamycin), also with high susceptibility to the fluoroquinilones: Moxifloxacin (100 â%) and Levofloxacin (86.7 â%). Sixteen (94.1 â%) of the 17 Rifampicin-susceptible strains were susceptible to all the eight antibiotics tested, while one (5.9 â%) was susceptible to Rifampicin and Isoniazid but resistant to the rest antibiotics. Conclusion: The study showed that there is high prevalence of TB and MDR-TB in Ekiti and Ondo States Nigeria, hence, to meet the SDG Target 3.3 of ending TB epidemic by 2030, culturing and antibiotic susceptibility testing should be carried out on every TB-positive sputum and the patients treated accordingly.