Diagnosing Tuberculosis in Resource Limited Settings: Experience from a Referral TB Clinic in North Central Nigeria

Background: Multidrug resistant tuberculosis (MDR-TB) which is TB that is resistant to at least isoniazid and rifampicin. Making a diagnosis of MDR-TB is a challenge in our environment as the access to facilities for diagnosis is difficult. This study tries to look at the pattern and possible determinants of MDR-TB and the challenges in making a diagnosis Method: This was a prospective study to identify pattern and possible determinants of MDR TB among MDR TB suspects managed in the Tuberculosis clinic of Jos University Teaching Hospital (JUTH) between January 2008 and October 2010. Sputum samples for patients that met the criteria were taken for culture and Drug susceptibility testing. All tests were confirmed using MGIT BACTEC. Results: Nine patients met study criteria. 77.7% were male. The mean age (SD) of the subjects was 42.55 (14.51); there was no significant difference between the mean age of the males and females. Two (22.2%) of study participants were HIV Seropositive. Four of the nine suspects (44%) of suspects had MDR TB confirmed. Conclusion: The study has highlighted some challenges with MDR TB diagnosis in Nigeria. Sputum microscopy remains a relevant screening tool for MDR TB among suspects who are HIV Seronegative. The low level of MDR TB diagnosis and lack of treatment portends huge public health risks and the addition of flouroquinolones to a failing regimen should be discouraged.