ADENOSINE DEAMINASE LEVEL IN DRUG RESISTANT TUBERCULOSIS

Tuberculosis (TB) remains one of the health problems in Nigeria and worldwide. Adenosine Deaminase acts in proliferation and differentiation of lymphocyte, especially T lymphocyte. It also acts in maturation of monocytes transforming them to macrophage. Adenosine Deaminase is a significant indicator of active cellular immunity. Adenosine Deaminase has been proposed to be a useful surrogate marker for TB because it can be detected in body fluids such as pleural, pericardial and peritoneal fluid. This study aimed to determine the relationship between Adenosine Deaminase and drug Resistant Tuberculosis (DR-TB) among patients attending Tuberculosis Clinic in Government Chest Hospital, Jericho, Oyo State, Nigeria. Methodology: A prospective case-control study involving thirty (30) Multi-Drug Resistance Tuberculosis patients and thirty (30) apparently healthy participants in Tuberculosis Clinic in Government Chest Clinic Hospital, Jericho, Oyo State, Nigeria. Theparticipants socio-demographic data was obtained using questionnaire. Sputum samples were collected from each patient from the two groups of participants in leak proof screw capped specimen containers. About 5 mL of venous blood sample was collected from the antecubital fossa of the study participants into vacutainer plain tubes. Sputum samples collected were analysed for Mycobacterium tuberculosis using Gene Xpert. Blood sample collected was analyzed for Adenosine Deaminase using ELISA method. The prevalence of MDR-TB was 0.18%, majority of MDR-TB were within age of 15-30 years with mean age 36.30±13.40 years with female having 63.3% and male 36.7%. Among MDR-TB, the mean±SD Adenosine Deaminase activity was 37.67±15.25 IU/L and among Healthy controls, the mean±SD of Adenosine Deaminase was 12.26±5.11 IU/L. There was significance increased in ADA activity among MDR-TB participants when compared to Healthy controls at p-value<0.05 (p=0.001). ADA level of 18 IU/L cut off point has a sensitivity of 90.0%, specificity of 87.0% and diagnostic accuracy of 88.0%. In conclusion, there was moderately high prevalence of MDR-TB among the study participants. There was increased in ADA levels among MDR-TB. High sensitivity and specificity of ADA activity was observed among MDR-TB. This might be a useful alternative test to diagnose and rule out drug resistance tuberculosis.