Mycobacterial Etiology of Pulmonary Tuberculosis and Association with HIV Infection and Multidrug Resistance in Northern Nigeria

Abstract

Objective. Data on pulmonary tuberculosis (TB) caused byMycobacterium tuberculosis (MTB) complexin Nigeria are limited. We investigated species ofMTB complexin 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 MTBDRpluswere used to characterize theMTB complexspecies and their resistance to isoniazid and rifampicin.Results. Of the 1,603 patients enrolled, 375 (23%) hadMTB complexinfection: 354 (94.4%) hadMycobacterium tuberculosis; 20 (5.3%) hadMycobacterium africanum; and one hadMycobacterium bovis(0.3%). Cases were more likely to be male (AOR = 1.87, 95% CI : 1.42–2.46;P≤0.001), young (AOR = 2.03, 95% CI : 1.56–2.65;P≤0.001) and have HIV (AOR = 1.43, 95% CI : 1.06–1.92;P=0.032). 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% CI : 1.51–8.84;P=0.004; AOR : 4.43; 95% CI : 1.71–11.45P=0.002resp.), compared to cases without any resistance.Conclusion.Mycobacterium tuberculosisremained the predominant specie in TB in this setting followed byMycobacterium africanumwhileMycobacterium boviswas rare. The association of TB drug resistance with HIV has implications for TB treatment.