A Retrospective Analysis of GeneXpert-Detected Tuberculosis and Rifampicin Resistance in a DOTS Clinic of Yobe State University Teaching Hospital Damaturu, Yobe state, Nigeria.

Abstract

Background: Tuberculosis (TB) remains a major public health problem in Nigeria, with increasing concerns about rifampicin-resistant TB (RR-TB). The Xpert MTB/RIF assay is routinely used for rapid detection of Mycobacterium tuberculosis (MTB) and rifampicin resistance in Directly Observed Treatment Short-course (DOTS) clinics, but local data from Yobe State are scarce. This study aimed to determine the prevalence of Xpert MTB/RIF-detected TB and rifampicin resistance among the DOTS clinic patients. Methods: A retrospective review of DOTS clinic and Xpert MTB/RIF registers was conducted from January 2023 to December 2025. The study utilized only laboratory-based data. The laboratory samples were sputum specimens submitted for Xpert MTB/RIF assay. All patients with presumptive TB who had Xpert testing during the study period were included. Data on age, sex, test date, MTB result, and rifampicin resistance were extracted. Data were analyzed using SPSS version 26.0 (IBM Corp, Armonk, NY, USA). Associations were assessed using chi-square or Fisher’s exact tests. Multivariate binary logistic regression identified independent predictors. Statistical significance was set at p < 0.05. Results: Of 386 individuals with presumptive tuberculosis, MTB was detected in 153 (39.6%). Among MTB-positive cases, 33 (21.6%) had rifampicin resistance. Males constituted 63.5% of participants, and 25.9% were aged 21–30 years. On multivariate analysis, age 21–30 years (AOR = 2.31, 95% CI: 1.10–4.84, p = 0.027), age 31–40 years (AOR = 2.22, 95% CI: 1.02–4.83, p = 0.045), and male gender (AOR = 1.56, 95% CI: 1.01–2.43, p = 0.046) were independently associated with MTB detection. No significant predictors of rifampicin resistance were identified. Conclusion: There is a high burden of TB and considerable RR-TB among patients attending the DOTS clinic at YSUTH. Young adult males had higher odds of MTB detection. Findings highlight the need to strengthen TB control measures, expand rapid molecular diagnostics, and enhance RR-TB surveillance in Yobe State.

Keywords: Tuberculosis; Rifampicin resistance, Xpert MTB/RIF, Nigeria, DOTS, Retrospective study