Research Article | | Peer-Reviewed

Exploring the Pattern of Resistance to Anti-Tuberculosis Drugs Among Tuberculosis Patients in Kwara State, Nigeria

Received: 9 November 2024     Accepted: 22 November 2024     Published: 24 January 2025
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Abstract

Tuberculosis (TB) remains a substantial global health challenge, particularly in Nigeria, which has the highest TB incidence in Africa, with approximately 590,000 new cases annually. Multidrug-resistant TB (MDR-TB) complicates treatment and control efforts, necessitating a deeper understanding of drug resistance patterns. This study used a descriptive cross-sectional design to investigate resistance to first- and second-line anti-TB drugs among TB patients in Kwara State, Nigeria. A multi-stage sampling technique was used to recruit 272 participants from selected Local Government Areas. Data collection included questionnaires and laboratory testing using the Hain Line Probe Assay (LPA) and GeneXpert MTB/Rif system. Results showed that age was a statistically significant factor, with resistance rates notably higher among younger individuals aged 20-29 years (p = 0.044), while no significant associations were found for gender (p = 0.166), ethnicity (p = 0.984 for first-line drugs; p = 0.601 for second-line), or educational level (p = 0.131 for first-line; p = 0.260 for second-line). Notably, 84.7% of participants who adhered to Directly Observed Treatment Short-course (DOTS) were sensitive to anti-TB drugs, but adherence alone did not exhibit a statistically significant association with resistance (p = 0.278), questioning assumptions about DOTS effectiveness in this context. Alcohol consumption emerged as a significant predictor of drug resistance (p = 0.0423), with patients consuming alcohol being six times more likely to develop resistance (OR = 6.025, 95% CI = 4.950 - 13.632) than non-drinkers, underscoring the need to address alcohol-related non-adherence to improve outcomes. Conversely, smoking, incarceration, and contact with TB patients showed no significant association with resistance, challenging global assumptions about these risk factors in the Nigerian context. This study highlights the complex nature of TB drug resistance, influenced by socio-demographic and behavioral factors unique to local contexts. The absence of statistically significant correlations for several known risk factors, such as smoking (p = 0.761) and prior TB contact (p = 0.2165), suggests that interventions in Nigeria should be localized and tailored to specific populations rather than relying on generalized global models. Comprehensive strategies targeting alcohol use and younger age groups, alongside strengthened healthcare delivery, are essential to curbing the spread of drug-resistant TB strains in Nigeria.

Published in International Journal of Infectious Diseases and Therapy (Volume 10, Issue 1)
DOI 10.11648/j.ijidt.20251001.12
Page(s) 11-28
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Drug Resistance, Tuberculosis (TB), Adherence to Treatment, Socio-Demographic Factors, Multidrug-Resistant Tuberculosis (MDR-TB), Alcohol Consumption

References
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[20] Berhanu S, Alemayehu W, Shiferaw B, Abraham A. Prevalence and drug-resistance patterns of Mycobacterium tuberculosis among new smear-positive pulmonary tuberculosis patients in Eastern Ethiopia. Tuberc Res Treat. 2014; 2014: 753492.
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Cite This Article
  • APA Style

    Muhammed, O. R., Popoola, I. O., Uthman, M. M. B., Daniel, E. O., Bello, A. M., et al. (2025). Exploring the Pattern of Resistance to Anti-Tuberculosis Drugs Among Tuberculosis Patients in Kwara State, Nigeria. International Journal of Infectious Diseases and Therapy, 10(1), 11-28. https://doi.org/10.11648/j.ijidt.20251001.12

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    ACS Style

    Muhammed, O. R.; Popoola, I. O.; Uthman, M. M. B.; Daniel, E. O.; Bello, A. M., et al. Exploring the Pattern of Resistance to Anti-Tuberculosis Drugs Among Tuberculosis Patients in Kwara State, Nigeria. Int. J. Infect. Dis. Ther. 2025, 10(1), 11-28. doi: 10.11648/j.ijidt.20251001.12

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    AMA Style

    Muhammed OR, Popoola IO, Uthman MMB, Daniel EO, Bello AM, et al. Exploring the Pattern of Resistance to Anti-Tuberculosis Drugs Among Tuberculosis Patients in Kwara State, Nigeria. Int J Infect Dis Ther. 2025;10(1):11-28. doi: 10.11648/j.ijidt.20251001.12

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  • @article{10.11648/j.ijidt.20251001.12,
      author = {Oyeniyi Rasheed Muhammed and Israel Olukayode Popoola and Muhammed Mubashir Babatunde Uthman and Ebenezer Obi Daniel and Ahmed Mamuda Bello and Taiwo Aderemi Popoola and Michael Avwerhota and Adebanke Adetutu Ogun and Celestine Emeka Ekwuluo and Aremu Samuel Danladi and Michael Olabode Tomori and Adedamola Amos Ogundeji and Jacob Adebowale Adewole},
      title = {Exploring the Pattern of Resistance to Anti-Tuberculosis Drugs Among Tuberculosis Patients in Kwara State, Nigeria
    },
      journal = {International Journal of Infectious Diseases and Therapy},
      volume = {10},
      number = {1},
      pages = {11-28},
      doi = {10.11648/j.ijidt.20251001.12},
      url = {https://doi.org/10.11648/j.ijidt.20251001.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20251001.12},
      abstract = {Tuberculosis (TB) remains a substantial global health challenge, particularly in Nigeria, which has the highest TB incidence in Africa, with approximately 590,000 new cases annually. Multidrug-resistant TB (MDR-TB) complicates treatment and control efforts, necessitating a deeper understanding of drug resistance patterns. This study used a descriptive cross-sectional design to investigate resistance to first- and second-line anti-TB drugs among TB patients in Kwara State, Nigeria. A multi-stage sampling technique was used to recruit 272 participants from selected Local Government Areas. Data collection included questionnaires and laboratory testing using the Hain Line Probe Assay (LPA) and GeneXpert MTB/Rif system. Results showed that age was a statistically significant factor, with resistance rates notably higher among younger individuals aged 20-29 years (p = 0.044), while no significant associations were found for gender (p = 0.166), ethnicity (p = 0.984 for first-line drugs; p = 0.601 for second-line), or educational level (p = 0.131 for first-line; p = 0.260 for second-line). Notably, 84.7% of participants who adhered to Directly Observed Treatment Short-course (DOTS) were sensitive to anti-TB drugs, but adherence alone did not exhibit a statistically significant association with resistance (p = 0.278), questioning assumptions about DOTS effectiveness in this context. Alcohol consumption emerged as a significant predictor of drug resistance (p = 0.0423), with patients consuming alcohol being six times more likely to develop resistance (OR = 6.025, 95% CI = 4.950 - 13.632) than non-drinkers, underscoring the need to address alcohol-related non-adherence to improve outcomes. Conversely, smoking, incarceration, and contact with TB patients showed no significant association with resistance, challenging global assumptions about these risk factors in the Nigerian context. This study highlights the complex nature of TB drug resistance, influenced by socio-demographic and behavioral factors unique to local contexts. The absence of statistically significant correlations for several known risk factors, such as smoking (p = 0.761) and prior TB contact (p = 0.2165), suggests that interventions in Nigeria should be localized and tailored to specific populations rather than relying on generalized global models. Comprehensive strategies targeting alcohol use and younger age groups, alongside strengthened healthcare delivery, are essential to curbing the spread of drug-resistant TB strains in Nigeria.
    },
     year = {2025}
    }
    

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    T1  - Exploring the Pattern of Resistance to Anti-Tuberculosis Drugs Among Tuberculosis Patients in Kwara State, Nigeria
    
    AU  - Oyeniyi Rasheed Muhammed
    AU  - Israel Olukayode Popoola
    AU  - Muhammed Mubashir Babatunde Uthman
    AU  - Ebenezer Obi Daniel
    AU  - Ahmed Mamuda Bello
    AU  - Taiwo Aderemi Popoola
    AU  - Michael Avwerhota
    AU  - Adebanke Adetutu Ogun
    AU  - Celestine Emeka Ekwuluo
    AU  - Aremu Samuel Danladi
    AU  - Michael Olabode Tomori
    AU  - Adedamola Amos Ogundeji
    AU  - Jacob Adebowale Adewole
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    DO  - 10.11648/j.ijidt.20251001.12
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    JF  - International Journal of Infectious Diseases and Therapy
    JO  - International Journal of Infectious Diseases and Therapy
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    PB  - Science Publishing Group
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    AB  - Tuberculosis (TB) remains a substantial global health challenge, particularly in Nigeria, which has the highest TB incidence in Africa, with approximately 590,000 new cases annually. Multidrug-resistant TB (MDR-TB) complicates treatment and control efforts, necessitating a deeper understanding of drug resistance patterns. This study used a descriptive cross-sectional design to investigate resistance to first- and second-line anti-TB drugs among TB patients in Kwara State, Nigeria. A multi-stage sampling technique was used to recruit 272 participants from selected Local Government Areas. Data collection included questionnaires and laboratory testing using the Hain Line Probe Assay (LPA) and GeneXpert MTB/Rif system. Results showed that age was a statistically significant factor, with resistance rates notably higher among younger individuals aged 20-29 years (p = 0.044), while no significant associations were found for gender (p = 0.166), ethnicity (p = 0.984 for first-line drugs; p = 0.601 for second-line), or educational level (p = 0.131 for first-line; p = 0.260 for second-line). Notably, 84.7% of participants who adhered to Directly Observed Treatment Short-course (DOTS) were sensitive to anti-TB drugs, but adherence alone did not exhibit a statistically significant association with resistance (p = 0.278), questioning assumptions about DOTS effectiveness in this context. Alcohol consumption emerged as a significant predictor of drug resistance (p = 0.0423), with patients consuming alcohol being six times more likely to develop resistance (OR = 6.025, 95% CI = 4.950 - 13.632) than non-drinkers, underscoring the need to address alcohol-related non-adherence to improve outcomes. Conversely, smoking, incarceration, and contact with TB patients showed no significant association with resistance, challenging global assumptions about these risk factors in the Nigerian context. This study highlights the complex nature of TB drug resistance, influenced by socio-demographic and behavioral factors unique to local contexts. The absence of statistically significant correlations for several known risk factors, such as smoking (p = 0.761) and prior TB contact (p = 0.2165), suggests that interventions in Nigeria should be localized and tailored to specific populations rather than relying on generalized global models. Comprehensive strategies targeting alcohol use and younger age groups, alongside strengthened healthcare delivery, are essential to curbing the spread of drug-resistant TB strains in Nigeria.
    
    VL  - 10
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Author Information
  • Department of Public Health, Ministry of Health, Ilorin, Nigeria

  • Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria

  • Department of Epidemiology and Community Health, College of Health Sciences, University of Ilorin, Ilorin, Nigeria

  • Department of Public Health, Swansea University, Swansea, United Kingdom; Department of Public Health, Texila American University, Georgetown, Guyana

  • Department of Public Health, Texila American University, Georgetown, Guyana

  • Department of Research, Smartnovation Limited, Birmingham, United Kingdom

  • Department of Public Health, Atlantic International University, Hawaii, United States of America

  • Department of Policy Governance Liaison and Support, International Organization for Migration, Abuja, Nigeria

  • Department of Health and Nutrition Sector, International Medical Corps, Kyiv, Ukraine

  • Department of Emergency Preparedness and Response, World Health Organization, Maiduguri, Nigeria; Department of Health and Nutrition, Samaritan Purse Country Office, Juba, South Sudan

  • Department of Public Health, Texila American University, Georgetown, Guyana

  • Department of Defense, Walter Reed Army Institute of Research-Africa Embassy of the United States of America, Abuja, Nigeria

  • Department of Public Health, Brits District Hospital, Bojanala District, Rustenburg, South Africa

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