Drug resistance patterns of Mycobacterium tuberculosis complex and risk factors associated with multidrug-resistant tuberculosis in the upper southern part of Thailand

Abstract


 Background: this study aimed to assess the drug resistant pattern of Mycobacterium tuberculosis complex (MTBC) and the risk factors associated to multidrug-resistant tuberculosis cases (MDR-TB) in upper part of southern Thailand. 
 Methods: a total of 3238 TB cases was retrieved from a database of the office of prevention and control disease region 11. Only 1008 cases were confirmed by culture growth for Mycobacterium tuberculosis and drug-susceptibility testing (DST) during a period of 4 years (January 2013 to December 2016). The risk factors, including gender, age group, residence place, and history of treatment were analysed using multivariate logistic regression to predict the MDR-TB cases. 
 Results: among 1008 TB cases included in study, 77.4% of them were males, 31.5% lived in rural area with median age of 45.0 years (IQR = 23.0), 27.6% were retreatment for tuberculosis, 25.9%, 10.8%, 3.0%, 10.7% and 9.1 were determined to be resistant to isoniazid, rifampicin, ethambutol, streptomycin and MDR-TB, respectively. Adjusted odds ratios (95% confidence interval) of MDR-TB were 5.4 (2.68-11.03), and 4.2 (2.10, 8.45) for retreatment patients, and on treatment patients, respectively. 
 Conclusions: drug resistance tuberculosis is considerable problem in upper part of southern Thailand. Major risk factors involved previous history of TB treatment. Thus, it emphasizes on patients who had a history of previous TB treatment. 

Patterns of Presentation of Drug-Resistant Tuberculosis in Nigeria: A Retrospective File Review

“…However, our result was lower than the DR-TB proportion of 72.4% recorded in Bangalore and that of 76.4% indicated for Nigeria [23,26], but higher than those calculated in India (20.4%), Turkey (38.7%) and Northern Iran (8.2%) [22,24,25] and comparable to that of 69.4% found in Northern Kernataka [27]. The proportion of MR-TB in our study was lower than that reported for Turkey (37.8%) but higher than that (4.2%) for Bangalore [23,25]; however, the reported percentage of 9.1% for RR-TB in our study is comparable to those of 10.8% recorded in Northern Thailand and 10.2% determined in China [20,28]. According to the WHO, a rifampicin resistance of less than 3% for non-MDR-TB is a good quality performance indicator [29].…”

“…The low DR-TB odds in these zones might be largely attributed to poor access to and availability of diagnostic facilities for DR-TB, rather than to a low prevalence. This is in tandem with a report from South Thailand where people in the rural areas would most likely harbor DR-TB due to poor access to culture and DST for first-line drugs [20]. The situation in the Northeast is further compounded by the civil unrest caused by Boko Haram insurgents, resulting in socioeconomic problems, a major factor for the spread of DR-TB [21].…”