Ekundayo Joseph OWOLABI2025-10-032025-10-032024-12Kate TurabiaP.hDhttps://repository.lcu.edu.ng/handle/123456789/1168Drug-resistant tuberculosis has been implicated in about 13% of all antimicrobial resistance deaths all over the world. Limited studies have been able to report the genomic characterisation of the multi-drug resistant (MDR) strain of M. tuberculosis in Nigeria. Undernutrition is a factor implicated as a cause of immune deficiency in most tuberculosis (TB) patients. The effects of micronutrients as adjuvant therapy in the management of tuberculosis have not been well documented in Nigerian TB patients. This study was designed to investigate the possible influence of zinc, selenium and iron supplements on TB patients undergoing intensive anti-TB therapy and also compare the genomic sequence of MDR TB with drug-sensitive Tubercle bacilli. One hundred newly diagnosed patients with drug-sensitive (DS) M. tuberculosis patients were recruited after the screening of sputum at the molecular level. Ten MDR positive M. tuberculosis and twenty-five normal individuals (controls) who were mycobacterium negative screened by Genxpert at Jericho Chest Government Hospital, Ibadan also participated in this study. The 100 drug-sensitive positive M. tuberculosis patients were classified into 4; groups 1-3 had anti-TB drugs plus iron, selenium or zinc supplementation, while group 4 had anti-TB drugs only. Baseline and 2 months post-treatment weights were measured, and blood samples were collected. MDR TB and DS sputum samples were used for the culture and genomic characterisation of M. tuberculosis. Results showed that baseline weights were significantly (p<0.05) lower when compared with the controls. After two months, patients on iron and selenium supplementation showed a significant increase in weight compared to the baseline values. Baseline levels of ferritin, IgG, C3, CRP, and D-dimer were significantly (p<0.05) higher, while levels of Hb, iron, selenium, zinc, and albumin were significantly (p<0.05) lower compared with controls. However, patients on Fe, Se and Zn supplementation had significantly higher levels after 2 months of treatment. This study identified the rpoB gene and KatG gene in MDR strains of M. tuberculosis. The phylogenetic analysis showed that some drug-sensitive and drug-resistant positive TB had clusters of both M. tuberculosis and M. bovis. It could be concluded that M. bovis shared similar clusters with M. tuberculosis probably due to a gene mutation that could accounts for drug resistance in MDR-TB. It may be necessary to consistently conduct a phylogenetic analysis of samples to identify which samples have a cluster common to MTB and M. bovis. This could help in reducing MDR-TB infection and possibly decrease the number of deaths. Consumption of micronutrients seems to have have effects on D-dimer, C- v reactive protein, complement factor-3, iron, ferritin and albumin, possibly by enhancing metabolic activities, reducing inflammation, preventing iron deficiency anaemia, reducing intravascular coagulation, and modulating immune response of patients to infection. Keywords: DNA sequencing, Immune system, Micronutrients, Multi-drug resistance, Tuberculosis-infection, Word Count: 429enDNA sequencingImmune systemMicronutrientsMulti-drug resistanceTuberculosis-infectionThesis