OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients’ adherence to treatment, and to reduce contact with MDR-TB patients.

Background: Nomadic life of Nuaulu Tribe results in rearing pattern, eating pattern, and food consumption which affect their nutritional status.Objective: To identify the relationship between rearing pattern, eating pattern, nutrient intake, and nutritional status of under-fives of Nuaulu tribal community at Subdistrict of Amahai, District of Maluku Tengah, Province of Maluku.Method: This was an observational analytical study with cross sectional design. Subjects of the study were 68 under-fives of age 12 to 60 months from Nuaulu Tribal community at Sub district of Amahai. Data of rearing pattern were obtained from interviewing using questionnaire, data of eating pattern from food frequency questionnaire, data of nutrient intake from recall 24 hours, and data of nutritional status from anthropometric measurement. Data analysis used bivariable with chi-square, multivariate with double logistic regression.Results: Most samples had low category of rearing pattern (77.9%) and eating pattern (66.2%); whereas samples intake of energy and protein belonged to adequate category, that were 73.6% and 72.0%, respectively. Nutritional status based on index of weight/age of 20.6% samples belonged to undernourished category and 51.5% samples belonged to stunted category based on index of length/age. There were no significant relationship between rearing pattern and nutritional status based on index of weight/length and weight/age (p > 0.05), but there was relationship between them based on index of length/age (p < 0.05). Eating pattern and nutritional status based on index of weight/length and weight/age had no relationship (p > 0.05), but between eating pattern and nutritional status based on index of length/age had relationship (p < 0,05). There was significant relationship between energy intake and nutritional status based on index of weight/age and length/age (p < 0.05), but there was not based on weight/length index (p > 0.05). There was significant relationship between protein intake and nutritional status based on index of weight/age and length/age (p < 0.05); however the relationship was insignificant based on index of weight/length.Conclusion: There was significant relationship between rearing pattern and nutritional status based on index of length/age and so was between eating pattern and nutritional status based index of length/age. Energy, protein intake and nutritional status based on index of weight/age and length/age also had significant relationship.

The low coverage of exclusive breastfeeding is due to the lack of public understanding of the benefits and importance of exclusive breastfeeding for infant aged 0–6 months, so it is necessary to empower posyandu cadre as breastfeeding counsellor who provide counselling for mothers to Nania health center as counsellor breastfeeding. The purpose of this study is to improving the knowledge and skills of cadres through counseling training of breastfeeding at Nania Health Center Ambon. The community service partner is Nania Health center. The method used is training, assistance, monitoring and evaluation. The number of cadres trained was 40 people. The training took place at Nania health care, on 23–27 October 2019. There was an increase in the knowledge level of cadres about breastfeeding after being given breastfeeding counseling training, where most of the knowledge levels were good (67.5%). Cadres are skilled in providing breastfeeding counselling to mothers who have babies aged 0-6 months or pregnant women.