Risk factors for multidrug-resistant tuberculosis among tuberculosis patients: a case-control study

Abstract

BackgroundMultidrug-resistant tuberculosis (MDR-TB) did not receive major attention until recently in sub-Saharan Africa where the tuberculosis incidence and risk factors are highest. Factors leading to development of drug resistance need to be understood to develop appropriate control strategies for national programs. The objective of this study was to identify the risk factors for MDR-TB among tuberculosis patients.MethodsA case-control study was conducted to assess sociodemographic, behavioral and clinical risk factors using a structured questionnaire and clinical record reviewing. The data were entered and analyzed using SPSS windows version 16. Descriptive analysis was done to generate summary values for the variables and those significant variables in the bivariate analysis at p-value less than 0.25 were entered to multivariable logistic regression to identify independent determinants. Statistical significance was declared at p-value less than or equal to 0.05.ResultsA total of 90 cases and 90 controls were included in the study. Age of respondents (adjusted odds ratio [AOR] =7; 95% confidence interval [CI]: 2.6–24.5), living in a household with only one room (AOR=5; 95%CI: 1.68–15.38), history of previous treatment (AOR=21; 95% CI: 17.8–28) and being HIV infected (AOR=3.1; 95%CI: 1.02–9.4) were found to be independent predictors of MDR-TB.ConclusionIn light of these findings, the strategies in controlling MDR-TB should emphasize on patients with HIV coinfection, young patients, those who have a history of previous treatment, and those living in crowded places.

Kejadian Tuberkulosis Multi Drug Resistant di RSUP dr. Kariadi

“…Berdasarkan hasil penelitian menunjukkan bahwa variabel pendapatan memiliki interval kepercayaan 1,133-4.317 (tidak mencakup angka 1) dan p value sebesar 0,030 < α (0,05), yang artinya ada hubungan antara pendapatan dengan kejadian TB MDR. Penelitian ini sejalan dengan pada penelitian Workicho (2017) yang menyebutkan bahwa pendapatan bulanan dengan OR= 4,5 dan 95%CI= 1,67-12,38 didapatkan dari pendapatan bulanan tinggi. Hasil berbeda ditemukan pada penelitian Fauziah dan Sudaryo (2013), yang menyatakan bahwa pendapatan tidak mempunyai hubungan dengan kejadian TB MDR, hal ini dibuktikan dengan nilai p= 0,133.…”

Epidemiology of Drug Resistant Tuberculosis in Samtse General Hospital, Bhutan: A Retrospective Study

“…This has been seen in other studies done in other countries. [12][13][14][15][16] Drug resistance is known to occur due to inappropriate use of anti-tuberculosis drugs. 2 Younger people are more likely to develop drug resistant TB.…”

“…2 Young being more active members of the community, increases their contact with MDR-TB patients thus increasing the probability of acquiring TB [14][15][16][17] as well as their reluctance and irregular intake of drugs. 13 It is a concern to see an increase in the number of MDR-TB cases in Bhutan as MDR-TB is associated with low treatment success, higher drug reactions and is comparatively more expensive. Multiple factors are responsible for development of MDR-TB like poor drug adherence, low income, young age, alcohol consumption, low educational status.…”

Progression from tuberculosis to multi drug resistance-TB in revised national tuberculosis control programme: perspectives from health system care givers

“…These factors may explain the high risk of MDR-TB among TB patients, particularly in countries of the former Soviet Union, where anti-TB drug shortages and a disruption in healthcare services characterized the early years following their independence over two decades ago. 27…”