%0 Journal Article
%T Mycobacterial Etiology of Pulmonary Tuberculosis and Association with HIV Infection and Multidrug Resistance in Northern Nigeria
%A Gambo Aliyu
%A Samer S. El-Kamary
%A Alash'le Abimiku
%A Nicholas Ezati
%A Iwakun Mosunmola
%A Laura Hungerford
%A Clayton Brown
%A Kathleen J. Tracy
%A Joshua Obasanya
%A William Blattner
%J Tuberculosis Research and Treatment
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/650561
%X Objective. Data on pulmonary tuberculosis (TB) caused by Mycobacterium tuberculosis (MTB) complex in Nigeria are limited. We investigated species of MTB complex in TB cases from northern Nigeria. Methods. New TB suspects were enrolled, screened for HIV and their sputum samples were cultured after routine microscopy. Genotypes MTBC and MTBDRplus were used to characterize the MTB complex species and their resistance to isoniazid and rifampicin. Results. Of the 1,603 patients enrolled, 375 (23%) had MTB complex infection: 354 (94.4%) had Mycobacterium tuberculosis; 20 (5.3%) had Mycobacterium africanum; and one had Mycobacterium bovis (0.3%). Cases were more likely to be male (AOR = 1.87, 95% CIˋ:ˋ1.42每2.46; ), young (AOR = 2.03, 95% CIˋ:ˋ1.56每2.65; ) and have HIV (AOR = 1.43, 95% CIˋ:ˋ1.06每1.92; ). In 23 patients (6.1%), the mycobacterium was resistant to at least one drug, and these cases were more likely to have HIV and prior TB treatment (AOR = 3.62, 95% CIˋ:ˋ1.51每8.84; ; AORˋ:ˋ4.43; 95% CIˋ:ˋ1.71每11.45 resp.), compared to cases without any resistance. Conclusion. Mycobacterium tuberculosis remained the predominant specie in TB in this setting followed by Mycobacterium africanum while Mycobacterium bovis was rare. The association of TB drug resistance with HIV has implications for TB treatment. 1. Introduction Nigeria has one of the highest burdens for TB in the world and remains a major target in the global control of the disease [1]. In 2011 an estimated 280,000 cases of TB (68% incident cases) were reported from Nigeria which corresponds to a prevalence rate of 280 per 100,000 population according the W.H.O global tuberculosis report of 2012. The incountry prevalence of pulmonary TB due to the Mycobacterium tuberculosis complex (MTB complex), particularly species other than Mycobacterium tuberculosis (M. tuberculosis) like mycobacterium bovis (M. bovis) and Mycobacterium africanum (M. africanum), [2, 3] is reportedly on the rise. However, this evidence is inconclusive, and data are insufficient on the prevalence of other Mycobacterial species raising question about the importance of the different species of Mycobacterium tuberculosis (MTB) complex causing tuberculosis (TB) in Nigeria. Other pathogenic species of the MTB complex group include Mycobacterium microti (M. microti) and Mycobacterium canetti (M. canetti), [4] and a recent addition, Mycobacterium mungi (M. mungi) [5]. Little is known about the epidemiology of MTB complex species associated with pulmonary TB in Nigeria due to limited facilities for TB culture and molecular assays until the
%U http://www.hindawi.com/journals/trt/2013/650561/