Multidrug resistant tuberculosis: prevalence and risk factors in districts of metema and west armachiho, Northwest Ethiopia

Abstract

BackgroundMulti drug resistant tuberculosis (MDR-TB) is an emerging challenge for TB control programs globally. According to World health organization, 2012 report Ethiopia stands 15th out of the 27 high priority countries in the world and 3rd in Africa. Updated knowledge of the magnitude of MDR-TB is so substantial to allocate resources, and to address prevention and control measures. Therefore, the aim of this study was to assess the prevalence of MDR-TB and associated risk factors in West Armachiho and Metema districts of North Gondar.MethodsA cross-sectional study was conducted in West Armachiho and Metema districts between February 01 and June 25, 2014. A total of 124 consecutive smear positive pulmonary tuberculosis patients were included in the study. Socio-demographic and possible risk factor data were collected using a semi-structured questionnaire. Drug susceptibility testing was first performed for rifampicin using GeneXpert MTB/RIF. For those rifampicin resistant strains, drug susceptibility testing was performed for both isoniazid and rifampicin to identify MDR-TB using the proportional method on LJ media. Data were analyzed using statistical Package SPSS version 20; binary logistic regression was used to assess the association. P-values < 0.05 were considered as statistically significant.ResultsOf 124 smear-positive pulmonary TB patients, 117 (94.4 %) were susceptible to Rifampicin, while 7 (5.7 %) were confirmed to be resistant to Rifampicin and Isoniazid. The overall prevalence of MDR-TB was 5.7 % (2.3 % among new cases and 13.9 % among previously treated cases). History of previous treatment (OR = 7, P = 0.025) was significantly associated risk factor for MDR-TB.ConclusionThe overall prevalence of MDR-TB was 5.7 % among cases at five health centers and a history of previous treatment was found to be a risk factor for being infected by an MDR-TB strain. Therefore, maximizing early case detection and treatment, strengthening TB infection control activities and proper implementation of DOTS are recommended to reduce the burden of MDR-TB.

Rifampicin-resistance pattern of Mycobacterium tuberculosis and associated factors among presumptive tuberculosis patients referred to Debre Markos Referral Hospital, Ethiopia: a cross-sectional study

“…In Ethiopia, 2.3% of new TB cases and 17.8% of previously treated TB cases were estimated to have MDR [3]. Studies in Ethiopia reported 4.7–18.3% prevalence of rifampicin-resistant M. tuberculosis [6–10]. Mutations in a ‘hotspot’ region of 81 base pairs (bp) of rpoB gene have been found in about 96% of rifampicin (RMP) resistant M. tuberculosis [6].…”

Extensively Drug-Resistant Tuberculosis: Report and Literature Review on Two Cases Requiring Prolonged Treatment

“…Additionally, a study states that one important risk factor for acquiring MDR-TB is a history of previous TB treatment [13]. In contrast, for XDR-TB, the risk factors are family history of TB, socioeconomic status, co-morbidities, and previous intake of second-line injectable drugs [14]; while the risk factors for mortality from drug-resistant tuberculosis are previous TB episodes, diabetes history, education level, and HIV infection [15].…”

Zoonotic Tuberculosis: A Concern and Strategies to Combat

“…BCG vaccine is the only TB vaccine licensed for use in humans. BCG vaccine has variable levels of protection efficacy in humans against pulmonary TB in children and adults, ranging from 0-80% [68]. It is reported that the prevalence of MDR-TB in previously treated cases was 13.9% and in new cases only 2.3%, whereas the overall prevalence of MDR-TB was 5.7% in all cases [69].…”