Prevalence and Drug Resistance Patterns of Mycobacterium tuberculosis Among Patients Attending Tuberculosis Reference Centres in Northwest Nigeria

Abstract Background: Tuberculosis (TB) remains a significant public health challenge in Nigeria, particularly with the emergence of drug-resistant strains. Accurate detection of Mycobacterium tuberculosis (MTB) and its resistance patterns is essential for effective disease management and control. This study aimed to determine the prevalence of MTB, rifampicin resistance, and multidrug-resistant TB (MDR-TB) among patients attending tuberculosis reference centres in Northwest Nigeria. Methods: In this cross-sectional study, 503 sputum samples were collected from bacteriologically confirmed pulmonary TB patients across selected states in Northwest Nigeria. Samples were analyzed using smear microscopy, culture on Lowenstein–Jensen medium, and the GeneXpert MTB/RIF assay. Phenotypic drug susceptibility testing was performed for first- and selected second-line anti-TB drugs. Descriptive statistics and chi-square tests were used to summarize demographic characteristics, MTB detection rates, and drug resistance prevalence, with significance set at p < 0.05. Results: Of the 503 participants, 65% were male, with a mean age of 35 years. MTB was confirmed in all collected samples, yielding a detection rate of 100%. Rifampicin resistance was observed in 12.9% of isolates, while MDR-TB was detected in 6.4% of patients, predominantly among new TB cases (8.1%) compared to previously treated cases (0%) (p = 0.02). No significant association was found between rifampicin resistance and HIV status (p = 0.18). The highest TB burden was recorded in Sokoto (44.3%) and Kaduna (23.7%) states. Conclusion: The presence of rifampicin-resistant and MDR-TB among newly diagnosed patients indicates ongoing community transmission of resistant strains in Northwest Nigeria. These findings underscore the need for routine drug susceptibility testing and strengthened regional surveillance to guide timely and effective TB control interventions. Enhanced public health strategies targeting high-burden areas are essential to curb transmission and reduce the disease burden