EVALUATION OF NITRATE REDUCTASE ASSAY FOR DETECTION OF MULTI-DRUG RESISTANT MYCOBACTERIUM TUBERCULOSIS AMONG PATIENTS AT NATIONAL TUBERCULOSIS REFERENCE LABORATORY ZARIA NGERIA

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EVALUATION OF NITRATE REDUCTASE ASSAY FOR DETECTION OF MULTI-DRUG RESISTANT MYCOBACTERIUM TUBERCULOSIS AMONG PATIENTS AT NATIONAL TUBERCULOSIS REFERENCE LABORATORY ZARIA NGERIA

 

 

CHAPTER ONE

1.0 INTRODUCTION

1.1 Background of the Study

Tuberculosis (TB) continues to cause more deaths worldwide than any other infectious disease. The World Health Organization (WHO) estimated that in 2011, there were 8.7 million cases of TB, with nearly 1 million deaths among HIV-negative cases and 0.43 million deaths associated with HIV infection (WHO, 2012). More than 99% of deaths and 95% of new TB cases occur in middle- and low-income countries (Palomino, 2012). In the 2012 Global Tuberculosis Report estimates, expressed in rates per 100,000 populations, were 161 (25-420) for prevalence and 108 (50-186) for incidence. Case detection of all forms stood at 51% (29%-110%). The mortality rate for all forms of TB remains 27 (7-60) per 100,000 populations (46,000 deaths per year) (WHO, 2012). The majority of TB cases worldwide were in the South-East Asia (29%), African (27%) and Western Pacific (19%) regions. India and China alone accounted for 26% and 12% of total cases, respectively (WHO, 2013). Nigeria has one of the highest burdens of TB in the world and remains a major target in the global control of the disease (WHO, 2010). In 2011 an estimated 280,000 cases of TB (68%incident cases) were reported from Nigeria which corresponds to a prevalence rate of 280 per 100,000 populations according the WHO global tuberculosis report of 2012 (Gambo et al., 2013). Based on 2012 survey Nigeria ranked 4th among the highest tuberculosis burden countries in the world. The point estimates of TB prevalence rates are 318 and 524 per 100,000 population (15 years and above) respectively (WHO, 2014).

Multidrug-resistant TB (MDR-TB) is a form of TB that is difficult and expensive to treat because it fails to respond to two important first-line drugs, specifically, rifampicin (RIF) and isoniazid (INH) (Bwanga et al., 2010). Data from more than 100 countries collected during the last decade show that 5% of all TB cases have MDR-TB. There were an estimated 500,000 new MDR-TB cases in 2007. Twenty-seven countries accounted for 85% of all MDR-TB cases. The top five countries with the largest number of MDR-TB cases are India, China, the Russian Federation, South Africa and Bangladesh, while extensively drug resistant TB (XDR-TB) has been found only in 58 countries to date (Stop TB partnership, 2009; WHO, 2010) .The number of prevalent cases of MDR-TB in many parts of the world is estimated to be much higher than the number of incident case arising annually.

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EVALUATION OF NITRATE REDUCTASE ASSAY FOR DETECTION OF MULTI-DRUG RESISTANT MYCOBACTERIUM TUBERCULOSIS AMONG PATIENTS AT NATIONAL TUBERCULOSIS REFERENCE LABORATORY ZARIA NGERIA