Study: Drug-resistant tuberculosis increasing in Nigeria

BY SUNDAY OMEIKE

New research has found that an increasing incidence of drug-resistant tuberculosis (TB) cases are beginning to manifest in Nigeria.

The new study, which was published recently on Nature, discovered the presence of mutations that confer resistance to treatment in two tuberculosis patients from samples collected in 2019 but re-investigated using the latest molecular-based technology.

The research was carried out by the African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Osun state, in collaboration with the Centre for Tuberculosis Research (CTBR), Nigerian Institute of Medical Research (NIMR), Lagos state.

Tuberculosis remains the leading cause of death from a bacterial infectious disease, especially in low-income countries such as Nigeria. It can be resistant to both first and second-line drugs, resulting in the extensively drug-resistant tuberculosis (XDR TB),

The life-threatening infection is caused by Mycobacterium tuberculosis, a globally distributed bacterium grouped into nine lineages, including the Beijing lineage.

This lineage, previously limited to Eurasia, has since spread across the world — including Nigeria — due to human migration and also led to the difficulty in treating drug-resistant TB.

Although suspected since 2011, this is the first time it is confirmed in Nigeria. This was made possible through whole-genome sequencing (WGS) technology that improves on presently used diagnostic procedures.

During the study, the researchers found evidence of factors that confirm the presence of drug-resistance tuberculosis which would be undetected by present diagnostic methods, indicating the possibility that several patients could already be carrying this TB lineage.

“This infers that a number of XDR TB cases will go undetected,” the report noted.

Follow-up of the patients showed that one died from complications related to both TB and HIV. The second patient also failed to complete treatment due to severe side effects, a dangerous outcome that could see such an individual spreading the hard-to-treat TB lineage among newly infected people in the country.

The study authors further advised that these inadequacies can be eliminated if WGS, a technology that is becoming cheaply available, can be incorporated into TB diagnosis.

“[This situation] emphasizes the importance of WGS in accurately detecting multi-drug resistant and XDR TB, to ensure adequate and proper management treatment regimens for affected individuals,” they added.