The role of nontuberculous mycobacteria in the diagnosis, management and quantifying risks of tuberculosis in Tanga, Tanzania

  • Abubakar S. Hoza Sokoine University of Agriculture, Morogoro
  • Athumani M. Lupindu Sokoine University of Agriculture
  • Sayoki G. M. Mfinanga National Institute for Medical Research
  • Irmgard Moser Friedrich Loeffler Institut
  • Brigitte König University of Leipzig
Keywords: tuberculosis, nontuberculous mycobacteria, management, Tanzania

Abstract

Background: The role of nontuberculous mycobacteria (NTM) in tuberculosis (TB) diagnosis is well documented in many developing settings. However, this has not been the case in many resource poor settings like Tanzania. This study aimed at understanding the role of NTM in the diagnosis and management of TB in resource poor settings of Tanzania.

Methods: A cross‑sectional study was conducted in Tanga, Tanzania. Patients with symptoms suggestive of TB self-referred to health care facilities were recruited. Two sputum samples were collected for standard direct smear microscopy. Culture was performed using BacT/Alert 3D system, Löwenstein-Jensen and Gottsacker slopes. Identification of Mycobacterium tuberculosis and NTM was done by using GenoType®MTBC and GenoType®CM/AS, respectively.

Results: A total of 372 patients were involved in the study. Eighty-one (21.8%) patients were diagnosed as having M. tuberculosis by the isolation of the organism from cultures of sputum. Further analysis of culture showed that 8.1% (30/372) were NTM with 7/372 (1.9%) cases of NTM classified as pulmonary tuberculosis (PTB) patients. Ziehl Neelsen stain had a sensitivity of 68.8% and produced 10 false negative results. On the other hand, Fluorescence stain had a sensitivity of 85.7% and gave seven false negative samples when compared with culture results. Weight loss (p = 0.0001), fatigue (p = 0.003), fever (p = 0.038) and night sweats (p = 0.004), young population (18-40 years) (p = 0.0352), males (p = 0.0025) were important risk factors for TB. Four out of 30 NTM diagnosed by culture received first line anti‑TB treatment suggesting that a good proportion of patients (4/65, 6.2%) were mistreated as TB patients.

Conclusion: Inefficient screening of TB patients in resource poor settings and prevalent increase of NTM may contribute to over diagnosis of TB cases. The need to integrate NTM diagnosis in the routine management of TB is urgently needed for designing effective tuberculosis prevention and control strategies in the country.

Author Biographies

Abubakar S. Hoza, Sokoine University of Agriculture, Morogoro
Department of Veterinary Microbiology & Molecular Biology, Lecturer
Athumani M. Lupindu, Sokoine University of Agriculture

Department of Veterinary Medicine & Public Health, Lecture in Epidemiology

 

Sayoki G. M. Mfinanga, National Institute for Medical Research
National Institute for Medical Research, Muhimbili centre Director
Irmgard Moser, Friedrich Loeffler Institut
Institute of Molecular Pathogenesis, Principal Investigator
Brigitte König, University of Leipzig
Institute of Medical Microbiology and Epidemiology of Infectious Diseases, Professor. Dr.
Published
2016-04-03
How to Cite
HozaA. S., LupinduA. M., MfinangaS. G. M., MoserI., & KönigB. (2016). The role of nontuberculous mycobacteria in the diagnosis, management and quantifying risks of tuberculosis in Tanga, Tanzania. Tanzania Journal of Health Research, 18(2). https://doi.org/10.4314/thrb.v18i2.5
Section
Articles

Journal Identifiers


eISSN: 1821-9241
print ISSN: 1821-6404