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Study background: Tuberculosis including multi-drug resistant form is not adequately diagnosed in spite of the fact that it constitutes a major public health challenge. This study was carried out to obtain data on laboratory diagnosis of pulmonary tuberculosis at the three local government areas in Osun state, Nigeria. Methods: Six month pilot study was carried out at Iwo, Irewole and Ede North LGAs, all located in Osun state, Nigeria. Socio-demographic and clinical information of the subjects were obtained using a pre-tested questionnaire. Sputum samples were collected from symptomatic pulmonary tuberculosis patients, stained with Zeihl-Neelsen (ZN) reagents and cultured on egg-based Lowenstein-Jensen medium. The medium was incubated at 37°C for eight weeks. Acid Fast Bacilli was confirmed by repeat Z-N staining. Drug resistance testing of the isolates was done using Genotype MTBDRplus. Serum was screened for HIV test using recombinant ELISA. Those that were screened positive were retested using Capillus HIV 1 and 2.   Results: Of the 75 subjects studied, seven (9.3%) were over 60 years while the majority, 45 (76.0%) were aged 21-60 years. Thirty-four (45.3%) had their sputum positive for acid fast bacilli (AFB) while 24 (32.0%) were culture positive. Among the 24 isolates, 6 were identified to be non tuberculos mycobacteria (NTM) by molecular methods. The HIV prevalence rate was observed to be 18.6% among all the study participants. Six out of 34 AFB positive persons (17.6%) were also positive for HIV specific antibody, while eight (19.5%) of the AFB negative persons were positive for HIV. There is no significant difference in the incidence of TB between the HIV infected and uninfected groups (p>0.05).Among the 18 mycobacterial isolates (excluding NTM), one strain (5.5%) was found to be resistant to rifampicin and isoniazid (Multi-Drug Resistant-MDR) while three were resistant to isoniazid alone..   Conclusion: This pilot study reveals the existence of MDR-TB and warrants well designed studies to ascertain the magnitude of the problem.

journal of medical microbiology and diagnosis

Diagnosis of Pulmonary Tuberculosis Using Genotype MTBDRplus Assay in Three Local Government Primary Health Centres of Osun State, Nigeria- a Pilot Study