Multidrug-Resistant Tuberculosis (MDR-TB) Control Activities in Kano State, North West Nigeria: Progress so Far

Download Article

DOI: 10.21522/TIJPH.2013.SE.19.02.Art002

Authors : Musa K. Bawa, Mustapha Mukhtar, Ado Umar


Background. The emergence of MDR TB poses a great treat to global health. Progress in response to the global MDR/RR-TB crisis is dismal. There is need to intensify efforts.

Methods We mapped the gene experts in Kano state. We reviewed the MDR-TB patients line list using the National tuberculosis and leprosy control program (TBLCP) line listing template. The data was analyzed using Epi Info version 3.5.4 and Microsoft Excel 2007.

Results The number of Cepheid gene Xpert machines increased from 1 in 2013 to 18 in 15 (34.1%) of the 44 LGAs in 2018. A total of 288 MDR TB cases were managed in 2017 and 2018 in Kano state, of which 262 (90.1%) were cases identified within the 2 years, 26 (9.0%) were referred in from other states. Of the 288 cases managed, 225 (78.1%,) were enrolled, 6 (2.1%), died, 8 (2.7%) refused enrollment and 18 (6.3%) loss to follow up. Of the 68151 reported and tested cases, 60479 (88.7%) were MTB negative, 7672 (11.3%) were MTB positive. Of the 7672 MTB positive cases, 7313 (95.3%) were drug sensitive (DS MTB), 280 (3.7%) were MDR TB and 79 (1.0%) were indeterminate.

Conclusions We conclude that there is progress in the MDR TB control program of Kano state with number of gene Xpert machines increased over time. We found improvement in MDR TB enrollment rate by 24.4% from 2017 to 2018. However, there is need to intensify tracking of MDR TB cases for enrollment.

Keywords: Multidrug-resistant tuberculosis (MDR-TB), control, progress, Kano state, north west Nigeria.


[1].   WHO Global TB report. 2016. [cited 2018 January 22]. Available from:

[2].   WHO WHO END TB strategy? 2015. [cited 2018 January 22]. Available from:

[3].   World Health Organization: WHO report 2011. Global Tuberculosis Control: Surveillance, planning, Financing. WHO/HTM/TB/2010. Geneva, Switzerland: WHO; 2010.

[4]. Report A. International Union Against Tuberculosis and Lung Disease. Tuberculosis. 2006;(December).

[5]. Toungoussova O, Zellweger J, Spanevello A, Cirillo D, Lange C, Migliori GB. Epidemiology and clinical management of XDR-TB: a systematic review by TBNET. 2009;33(4):871–81.

[6]. National Tuberculosis and Leprocy Control Programme (NTBLCP); Federal Ministry of Health. Accessed from URL; on 15/10/19.

[7]. Fawcett IW, Watkins BJ nitial resistance of Mycobacterium tuberculosis in Northern Nigeria. Tubercle 1976; 57:71-3.

[8].   Osman E, Daniel O, Ogiri S, Awe A, Obasanya O, Adebiyi E, et al. Resistance of Mycobacterium tuberculosis to first- and second-line anti-tuberculosis drugs in South West, Nigeria. J Pulmon Resp Med 2012. doi: 10.4172/2161-105X.S6-001.

[9].   Mariandyshev A, Eliseev P. Drug-resistant tuberculosis threatens WHO’s End-TB strategy. Lancet Infect Dis. 17(7):674–675. [PubMed] [Google Scholar].

[10].  WHO Global TB report. 2017. [cited 2018 August 27]. Available from:

[11].  Weyer K, Falzon D, Jaramillo E, Zignol M, Fuad M, Raviglione M. (2017). Drug-Resistant Tuberculosis: What Is the Situation, What Are the Needs to Roll It Back? AMR control. Jul 26, 2017. Accessed on 14/10/13 from URL;

[12].  The World Gazetteer. Profile of Kano, the capital city of State. Archived from the original on 9 February2013. Retrieved 2007-03-27. Accessed on 07/10/2019 from URL:http://www.http/kano/profile.

[13].  Cuevas LE, Vassin MA, Al-Sonboli, Lawson N, BAhader J (2011) A multi-country non-inferioriy cluster randomize trial of front–loaded smear microscopy for the diagnosis of pulmonary tuberculosis. PLOS Med 8: l000403.

[14].  Hooja S, Pal N, Malhotra B, Goyal S, Kumar V (2011) Comparison of Ziehl- Neelsen and Auramine staining methods on direct and concentrated.

[15].  Carlton AA (2011) Gene Xpert: Agame changer for tuberculosis control? PLOS Medicine.

[16].  World Health Organisation (2012) WHO Nigeria supports introduction of Xpert MTB/RIF technology for diagnosis of MDRTB in Nigeria.

[17].  Papaventsis D, Ioannidis P, Evangelos V (2014) Tuberculosis diagnosis update: the new gene Xpert MTB /RIF assay. Hellenic centre for Disease Control and prevention. E-bulletin.

[18].  World Health Organisation (2010) WHO endorses new rapid tuberculosis test.

[19].  Gandhi NR, Moll A, Sturm AW, Pawinski R, Govender T, Lalloo U, et al. Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. Lancet. 2006 Nov 4;368(9547):1575–80.

[20].  Lawson L, Yassin MA, Abdurrahman ST, Parry CM, Dacombe R, Sogaolu OM, et al. Resistance to first-line tuberculosis drugs in three cities of Nigeria. Trop Med Int Health. 2011; 16:974–80. [PubMed] [Google Scholar].