title: Resistance to first-line tuberculosis drugs in three cities of Nigeria.
abstract: OBJECTIVE
  To determine the levels of resistance to first-line tuberculosis drugs in three cities in three geopolitical zones in Nigeria.
  
  
  METHODS
  A total of 527 smear-positive sputum samples from Abuja, Ibadan and Nnewi were cultured on BACTEC- MGIT 960. Drug susceptibility tests (DST) for streptomycin, isoniazid, rifampicin and ethambutol were performed on 428 culture-positive samples on BACTEC-MGIT960.
  
  
  RESULTS
  Eight per cent of the specimens cultured were multi-drug-resistant Mycobacterium tuberculosis (MDR-TB) with varying levels of resistance to individual and multiple first-line drugs. MDR was strongly associated with previous treatment: 5% of new and 19% of previously treated patients had MDR-TB (OR 4.1 (95% CI 1.9-8.8), P = 0.001) and with young adult age: 63% of patients with and 38% without MDR-TB were 25-34 years old (P = 0.01). HIV status was documented in 71%. There was no association between MDR-TB and HIV coinfection (P = 0.9) and gender (P > 0.2 for both).
  
  
  CONCLUSIONS
  MDR-TB is an emerging problem in Nigeria. Developing good quality drug susceptibility test facilities, routine monitoring of drug susceptibility and improved health systems for the delivery of and adherence to first- and second-line treatment are imperative to solve this problem.
authors.affiliation: Zankli Medical Centre, Abuja, Nigeria. lovettlawson@hotmail.com
authors.forename: L
authors.initials: L
authors.lastname: Lawson
authors.forename: M A
authors.initials: MA
authors.lastname: Yassin
authors.forename: S T
authors.initials: ST
authors.lastname: Abdurrahman
authors.forename: C M
authors.initials: CM
authors.lastname: Parry
authors.forename: R
authors.initials: R
authors.lastname: Dacombe
authors.forename: O M
authors.initials: OM
authors.lastname: Sogaolu
authors.forename: J N
authors.initials: JN
authors.lastname: Ebisike
authors.forename: G N
authors.initials: GN
authors.lastname: Uzoewulu
authors.forename: L O
authors.initials: LO
authors.lastname: Lawson
authors.forename: N
authors.initials: N
authors.lastname: Emenyonu
authors.forename: J O
authors.initials: JO
authors.lastname: Ouoha
authors.forename: J S
authors.initials: JS
authors.lastname: David
authors.forename: P D O
authors.initials: PD
authors.lastname: Davies
authors.forename: L E
authors.initials: LE
authors.lastname: Cuevas
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002947:Cities; D004977:Ethambutol / Q000494:pharmacology; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D009549:Nigeria; D012293:Rifampin / Q000494:pharmacology; D013183:Sputum / Q000382:microbiology; D013307:Streptomycin / Q000494:pharmacology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014504:Urban Health; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin