Rifampicin-resistant Mycobacterium tuberculosis complex in Niger: A 5-year retrospective analysis (2017–2022)

Background: Rifampicin-resistant Mycobacterium tuberculosis complex is a growing burden globally and is classified as a critical organism. This study aimed to determine the prevalence of Rifampicin-resistant tuberculosis (RR-TB) and associated risk factors in Niger Republic. Methods: This was a retrospective study, conducted from January 1, 2017, to December 2022 at GeneXpert sites in Niger. GeneXpert MTB/RIF was used to detect Mycobacterium tuberculosis complex (MTC) and the resistance to rifampicin. Multivariate logistic analysis was performed to identify risk factors for rifampicin resistance in Niger. Results: A total of 12970 patients were enrolled. The median age of patients was 39 years, with male predominant, sex ratio of 2.70. The overall, prevalence of MTC was 37.69% (4889/12970), among this 4.45% (210/4889) were children. Out of 4889 MTC positive cases, 479 (9.79%) were rifampicin-resistant, all from pulmonary tuberculosis: 111 (23,57%) new cases, 195 (41,40%) therapeutic failure, 153 (32,48%) relapsed cases, 12 (2,55%) treatment abandonment. Based on the univariate analysis, therapeutic failure (p=0.001), relapsed cases (p=0.001), and treatment abandonment (p=0.005), were significantly related to rifampicin resistance in Niger. Based on the multivariate analysis, only therapeutic failure (AOD: 6.62, 95%CI: 5.17-8.51, p<0.001) and relapsed cases (AOD: 3.08, 95%CI: 2.39-3.98, p<0.001) were the independents factors associated with rifampicin resistance. Conclusion: The prevalence of MTC resistance to rifampicin was relatively high in Niger. Therapeutic failure and relapsed cases represented the major factors favoring rifampicin resistance.