Prevalence of Mycobacterium Tuberculosis and Rifampicin-Resistant Tuberculosis Among Tuberculosis Presumptive Adults in Northern Ethiopia, 2016-2019

Abstract Background: Tuberculosis (TB) is the second leading cause of mortality from an infectious disease worldwide. Multidrug-resistant tuberculosis (MDR-TB), where rifampicin-resistant TB is the most contributor, remains a global health threat. There is scant data on MTB and rifampicin resistance (RR-MTB) using Gene Xpert MTB/RIF assay in Ethiopia, particularly in the study area. This study aimed at determining the prevalence of MTB and RR-MTB among presumptive TB patients in Tigray, Northern Ethiopia.Methods: A multi-center retrospective cross-sectional study was conducted from October 2019 to December 2019 among presumptive MTB patients from four governmental hospitals in Tigray regional state. Records of sputum sample results of presumptive MTB patients with Gene Xpert MTB/RIF assay from January 2016 to December 2019 were investigated. Data-extraction tool was used to collect data from registration books and analyzed using SPSS ver.21 statistical software. Statistically significant was set at P-value ≤ 0.05. Results: Out of the total 17,329 presumptive adult MTB patients who had submitted sputum samples for TB diagnosis, 16,437 (94.9%) had complete data and were included in the study. More than half (60.2%) of them were males and the age of the patients ranged from 18-98 years, with a mean age of 44.2 (±16.4 SD) years. The majority, 15,047(91.5%) and 11,750 (71.5%) of the participants were new cases and with unknown HIV status, respectively. Prevalence of MTB was 9.7% (95% CI: 9.2-10.2%) of these, rifampicin resistant-MTB was 8.7% (95% CI: 7.32-10.09%). Age (being greater than 29 years) [p < 0.001] and new cases [AOR= 0.46; 95%CI = 0.39, 0.53, p < 0.001] were associated with low TB infection. Whereas age groups of 18-29 years were associated with higher RR-MTB [AOR= 3.08; 95% CI= 1.07, 8.72, p = 0.036]. Gender (being male) [AOR= 0.68; 95 % CI= 0.47, 0.96, p= 0.032] and having no history of previous treatment [AOR= 0.29; 95 % CI= 0.202, 0.44, p < 0.001] were associated with lower RR-MTB. Conclusion: Nearly one-tenth of the presumptive tuberculosis patients tested positive for MTB; out of those, 8.7% were positive rifampicin-resistant-MTB. The high prevalence of TB and RR-MTB at a young age and previously treated cases calls for a concerted effort to improve and monitor TB treatment to reduce the problem.