Frequency of MTB and Rifampicin Resistance using Xpert-MTB/RIF Assay among Patients Attending National TB Control Program in Sana'a, Yemen

Abstract

Background: Mycobacterium tuberculosis is one of the major health problems in world It is the second-highest cause of death among communicable diseases. According to the World Health Organization, 9 million people fell ill with TB and 1.5 million died from TB. Over 95% of TB deaths occur in low- and middle-income countries. TB incidence rate is falling, but not fast enough In Yemen, MTB is a major public health problem, it was estimated that, Yemen MTB endemicity comes lower-middle-income. With an incidence ranged (177 and 277) of MTB in Yemen per 100000 pupation and mortality rate t ranged 12.2% to 21%. So we aimed this study to determine the Frequency of MTB and Rifampicin Resistance MTB among Patients Attending National TB Control Program. Material and method this study is a cross sectional study. Method: A total of 8896 specimens were collected from suspected Tuberculosis patients and all of them were initially screened for acid-fast bacilli through Zeihl Neelson (ZN) microscopy and positive samples were further assayed by Real-time Polymerase Chain Reaction (GeneXpert). Result: A total 551 (6.1%) were positive by either and or by both GeneXpert and ZN staining. of these, 476 (5.4%) were positive by both ZN and GeneXpert. whereas, the result of 75 remaining specimens was 65 of specimens were positive by GeneXpert and negative by ZN stain. While, ten specimens were negative by GeneXpert and positive for ZN stain. The frequency of MTB among males (6.4%) was higher than female (5.6%), but the risk was found higher among female (X² = 0.8, p < 0.361 and OR=1.1) as compared to males. the rate of infection was found higher 9.5% and 6.0% among age groups 21-30, and 31- 40 years old respectively. High prevalence rate of MBT infection among cases referrals from Taiz governorate (13.9% and OR= 0.4) followed by Amran, Al-Hodeida, Sana'a, and Mareb governorates with an account 9.4%, 7.9%, 7.0 and 6.2% respectively. Recent study revealed that, 28 ̸ 541 (5.2%) of MTB were rifampicin resistance. high resistant rate was found among males [(7.4%) P <0.019, and OR = 0.4] as compared to females [(3.0%) P <0.019, and OR = 2.6]. Insignificant in the difference of rifampicin resistant among different age groups. The rate of resistant was found higher (7.4%) among subjects aged 41-50 years old followed by 21-30, (6.5%) and > 60 (5.2%) years old On other hand, significance with high risk of resistant was found in the difference of MTB susceptibility pattern among infected patient resident the capital city of Sana'a.

Conclusion: We conclude that the high TB rates among age group 20 t0 40 years old, suggest that this age group may be an appropriate target group for TB vaccine trials including TB vaccine trials aiming to prevent infection.