Detection of Mycobacterium tuberculosis and rifampicin resistance by Xpert® MTB/RIF assay among presumptive tuberculosis patients in Addis Ababa, Ethiopia from 2014 to 2021

Getu Diriba; Ayinalem Alemu; Habteyes Hailu Tola; Kirubel Eshetu; Bazezew Yenew; Misikir Amare; Biniyam Dagne; Hilina Mollalign; Waganeh Sinshaw; Yeshiwork Abebaw; Getachew Seid; Mengistu Tadesse; Betselot Zerihun; Melak Getu; Shewki Moga; Abyot Meaza; Dinka Fekadu Gamtesa; Zigba Tefera; Amanuel Wondimu; Michael Hailu; Bedo Buta; Muluwork Getahun; Abebaw Kebede

doi:10.1016/j.ijregi.2022.09.001

Detection of Mycobacterium tuberculosis and rifampicin resistance by Xpert® MTB/RIF assay among presumptive tuberculosis patients in Addis Ababa, Ethiopia from 2014 to 2021

IJID Reg. 2022 Sep 8:5:97-103. doi: 10.1016/j.ijregi.2022.09.001. eCollection 2022 Dec.

Authors

Getu Diriba¹, Ayinalem Alemu^{1

2}, Habteyes Hailu Tola³, Kirubel Eshetu⁴, Bazezew Yenew¹, Misikir Amare¹, Biniyam Dagne¹, Hilina Mollalign¹, Waganeh Sinshaw¹, Yeshiwork Abebaw¹, Getachew Seid¹, Mengistu Tadesse¹, Betselot Zerihun¹, Melak Getu¹, Shewki Moga¹, Abyot Meaza¹, Dinka Fekadu Gamtesa¹, Zigba Tefera¹, Amanuel Wondimu¹, Michael Hailu¹, Bedo Buta¹, Muluwork Getahun¹, Abebaw Kebede^{5

6}

Affiliations

¹ National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
² Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
³ Department of Public Health, College of Health Sciences, Selale University, Fiche, Ethiopia.
⁴ USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia.
⁵ Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁶ Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.

Abstract

Objective: This study aimed to determine the frequencies and trends of Mycobacterium tuberculosis and rifampicin resistance among presumptive tuberculosis patients in Ethiopia, who were tested using the Xpert MTB/RIF assay between 2014 and 2021.

Methods: Data were collected retrospectively from patient registries. Laboratory-based data were extracted from the national tuberculosis (TB) referral laboratory database. All patients referred to the National Tuberculosis Reference Laboratory (NTRL) for TB diagnosis from all over the country between March 1, 2014 and September 30, 2021, and tested using the Xpert MTB/RIF assay, were included. The extracted data were entered into a Microsoft Excel sheet and analyzed by Statistical Package for Social Sciences (SPSS) version 23.

Results: Among a total of 13 772 individuals tested using the Xpert MTB/RIF assay, the majority (8223; 59.7%) were males, and 48.5% (6678) of the individuals were aged between 15 and 39 years. Mycobacterium tuberculosis (MTB) was detected in 17.0% (2347) of the examined individuals. Of the detected MTB cases, nearly 9.9% (233) were rifampicin resistant (RR-TB), while 24 (1.0%) were RR-intermediate. Among all RR-TB cases, more than half (125; 53.6%) were detected in males, and 105 were new TB cases. Extrapulmonary (EPTB) patients had a greater rate of rifampicin resistance (11.0%) than pulmonary (PTB) patients (9.6%).

Conclusion: The frequency of TB and RR-TB remains high in the study setting. RR-TB was found to have a statistically significant association with previous anti-TB medication treatment. As a result, improving treatment adherence in recognized instances could assist in preventing MTB and RR-TB cases.

Keywords: EPHI, Ethiopian Public Health Institute; EPTB, extrapulmonary tuberculosis; MDR, multidrug resistance; MTB, Mycobacterium tuberculosis; MTBC, Mycobacterium tuberculosis complex; Mycobacterium tuberculosis; NTRL, National Tuberculosis Reference Laboratory; PTB, pulmonary tuberculosis; RIF, rifampicin; RR-TB, rifampicin-resistant tuberculosis; SPSS, Statistical Package for Social Sciences; TB, tuberculosis; WHO, World Health Organization; Xpert MTB/RIF; frequency; rifampicin resistance.