Gender-Based Molecular Profiling of Drug Resistance–Associated Genetic Markers among Tuberculosis Patients Using Line Probe Assay

Background: Tuberculosis (TB) remains a major global public health challenge, complicated by the emergence of drug-resistant strains. Molecular detection of resistance-associated genes has become essential for early diagnosis and appropriate treatment. Gender-related differences in the molecular epidemiology of drug resistance remain inadequately explored. Aim: To evaluate gender-based differences in the distribution of resistance-associated genetic markers ( rpoB , katG , inhA , gyrA , gyr , rrs , and eis ) among TB patients. Methods: A cross-sectional molecular study was conducted among 317 bacteriologically confirmed TB patients. Genomic DNA extracted from clinical specimens was analyzed using line probe assay to detect wild-type (WT) and mutant probes associated with resistance to rifampicin, isoniazid, fluoroquinolones, and injectable drugs. Gender-wise comparisons were performed using the Chi-square test. Results: Of the 317 patients, 209 (66.0%) were males, and 108 (34.0%) were females. Male patients showed significantly a higher prevalence of rpoB (89.4% vs. 80.6%), katG (85.6% vs. 75.0%), inhA (87.5% vs. 77.8%), gyrA (86.6% vs. 71.0%), rrs (86.6% vs. 73.8%), and eis (86.6% vs. 75.7%) genes ( P < 0.05). Several WT probes were significantly more frequent in males, while selected mutations such as rpoB MUT3, katG MUT1, gyrA MUT3A, and gyrA MUT3C demonstrated significant gender associations. Conclusion: Distinct gender-based differences exist in the molecular distribution of TB drug resistance markers, with males exhibiting a higher prevalence of several resistance-associated genes. These findings highlight the importance of incorporating gender perspectives into TB molecular surveillance and control strategies.