Prevalence and Risk Factors of Rifampicin Resistant Mycobacterium Tuberculosis among Human Immune Virus Sero-Positive Patients in South Western Uganda

Abstract Background Tuberculosis is treated using rifampicin and isoniazid as the first line drugs, with rifampicin playing a pivotal role in the effective treatment of tuberculosis. However, resistance to rifampicin is common and used as a valuable surrogate marker for multi-drug resistant tuberculosis (MDR-TB). Furthermore, HIV co-infection complicates the management of PTB. Methods Across sectional study was conducted in South Western Uganda between December 2014 and May 2015. A total of 859 smear positive and smear negative HIV-positive individuals who were presumptive for TB, newly diagnosed and previously treated TB patients, aged ≥ 18years were enrolled. A standardized questionnaire was administered to patients who consented to collect their socio-demographic characteristics and risk factors for TB. Sputum samples were obtained from the participants and GeneXpert MTB/RIF assay performed. Data was analyzed for proportions and factors associated with rifampicin resistant TB (RR-TB) in a multivariate analysis. Results A total of 510 (59.4%) were male, 238 (27.8%) were new cases and 159 (18.5%) were M. tuberculosis positive. The prevalence of RR-TB was 09 (5.7%). Male HIV-positive individuals had a higher risk of contracting TB than females (P = 0.001). Rifampicin resistant M. tuberculosis was 06 (1.2%) among male and03 (0.9%) among female TB patients. Having rifampicin resistant M. tuberculosis was significantly associated, OR (95%CI: P value) with TB history 4.99 (95% CI; P = 0.001) and smoking tobacco 2.05 (95% CI: P = 0.001). Conclusion There is a considerable high prevalence of PTB in South western Uganda despite the low magnitude of RR-TB among HIV positive individuals. Risk factors such as history of TB, and smoking should be included in the preventive measures for better outcomes. Continuous screening of HIV-positive individuals for TB and RR-TB is highly recommended.