Prevalence of rifampicin resistance in pulmonary tuberculosis: A laboratory-based study

Tuberculosis (TB) remains a significant global public health challenge, particularly in low- and middle-income countries. The emergence of rifampicin-resistant tuberculosis further complicates control efforts. Despite national efforts, there are limited data on the prevalence of Mycobacterium tuberculosis and their rifampicin resistance in Ghana, especially at the facility level. This study aimed to determine the prevalence of Mycobacterium tuberculosis and rifampicin resistance among presumptive tuberculosis cases at the Ho Teaching Hospital over a three-year period. The study used a retrospective design and collected secondary data from the Microbiology Laboratory Unit of Ho Teaching Hospital between 2022 and 2024. Data on patient demographics, Mycobacterium tuberculosis detection, and rifampicin resistance were retrieved and analysed using descriptive and inferential statistics. Mycobacterium tuberculosis and rifampicin resistance were identified using the GeneXpert MTB/RIF assay. Statistical analyses were performed using STATA version 15 with statistical significance set at p < 0.05. Out of 2,225 presumptive tuberculosis cases, 203 tested positive for the infection, resulting in an overall prevalence of 9.1% (95% CI: 7.9-10.4). The prevalence was significantly higher among males (12.4%) compared to females (5.7%), and highest among young adults aged 18-24 years (12.8%). Of the 166 Mycobacterium tuberculosis-positive cases tested for rifampicin susceptibility, 3 (1.8%) were resistant. Although rifampicin resistance was more common among females and adults, the differences were not statistically significant. Although the detection rate of rifampicin resistance among newly diagnosed Mycobacterium tuberculosis cases was low (1.8%), it remains a significant public health concern, hence the need for enhancing surveillance systems and prioritising early detection strategies.