Prevalence and Epidemiological Distribution of Mycobacterium tuberculosis and Rifampicin-Resistant Tuberculosis Among Patients Attending Selected Health Facilities in South-Western Nigeria
Warrens Rose *
Department of Microbiology, Novena University, Ogume, Delta State, Nigeria.
Otoikhian, C.S.O.
Department of Microbiology, Novena University, Ogume, Delta State, Nigeria.
Akpeji, S.C.
Department of Microbiology, Novena University, Ogume, Delta State, Nigeria.
Bosah, B.O.
Department of Microbiology, Novena University, Ogume, Delta State, Nigeria.
Elkanah, D.S.
Department of Public Health Science, Taraba State University, Jalingo, Taraba State, Nigeria.
Otali, C.C
Department of Public Health Science, Taraba State University, Jalingo, Taraba State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Tuberculosis (TB) remains a major public health challenge in Nigeria, with emerging concerns regarding rifampicin-resistant tuberculosis (RR-TB). Geographic variations in Mycobacterium tuberculosis (MTB) prevalence and drug resistance patterns necessitate localised surveillance to inform evidence-based control strategies. This study aimed to determine the prevalence of MTB and rifampicin resistance among presumptive TB patients attending selected health facilities in south-western Nigeria, and to describe the epidemiological distribution across demographic variables. A cross-sectional, laboratory-based study was conducted among 324 presumptive TB patients recruited from health facilities in Osun, Oyo, and Lagos States. Sputum specimens were analysed using the Xpert MTB/RIF assay. Data were analysed using SPSS, with frequencies, percentages, and chi-square tests employed to examine associations between demographic variables and MTB detection. Statistical significance was set at p < 0.05. Overall MTB prevalence was 24.7% (80/324), with state-specific prevalence of 26.6% in Osun, 23.1% in Oyo, and 15.4% in Lagos. Among MTB-positive cases, 38.8% (31/80) exhibited rifampicin resistance. MTB-positive cases were equally distributed between males and females (50.0% each). The 20–29 and 30–39 years age groups accounted for 56.3% of MTB-positive cases. Artisans and traders together constituted 62.5% of MTB-positive participants. Among RR-TB cases, males represented 61.3%, and Osun State accounted for 67.7%. No statistically significant associations were observed between MTB detection and age (p = 0.081) or sex (p = 0.178). The findings indicate a substantial burden of MTB (24.7%) and an alarmingly high prevalence of rifampicin resistance (38.8%) in south-western Nigeria, exceeding global and several regional estimates. This study had several limitations. The unequal state-specific sample sizes limited the precision of comparisons, particularly in Oyo and Lagos States. Second, the facility-based design limits generalisation to the wider population. Finally, the cross-sectional design limits causal interpretation of the findings. These data emphasise the urgent need for enhanced diagnostic capacity, strengthened drug-resistance surveillance, and targeted interventions to mitigate transmission and improve treatment outcomes.
Keywords: Mycobacterium tuberculosis, rifampicin resistance, tuberculosis prevalence, Xpert MTB/RIF, drug-resistant TB