IDENTIFICATION OF DIFFERENT FACTORS LEADING TO THE DEVELOPMENT OF MULTIDRUG RESISTANCE TUBERCULOSIS.

Abstract

Background; Despite an overall decreasing incidence and mortality rate for tuberculosis (TB), multidrug resistance tuberculosis (MDR-TB) continues to be a serious threat to the current global tuberculosis control effort. Failure to control MDR-TB may lead to another era with TB being regarded as a fatal disease. Materials and Method; One hundred forty one cases confirmed MDR-TB patient by of either gender aged less than 60 years who were newly diagnosed or who were previously diagnosed cases were enrolled in this descriptive study. Demographic, socioeconomic, clinical as well as laboratory data were recorded for each patient by trained data collector. The data was collected through pre-tested close ended questionnaire. Drug resistant cases was labeled according to sputum culture Sensitivity report and GeneXpert for MTB and were assessed for different factors for MDR. Results; Our study comprised of 141 study cases of MDR TB, 71 (50.4%) were male patients and 70 (49.6 %) were female patients. Mean age of our study cases was 39.99 ± 9.15 years One hundred and five (74.5%) of our study cases were married while 36 (25.5%) were unmarried. Majority of our study cases were less educated as 47 (33.3%) were illiterate and 78 (55.3%) were having primary level of education. Majority of our study cases were living in slum areas and were having poor socioeconomic status as 77 (54.6%) were having their family income less than Rs. 10, 000 per month. Previous history of TB was present in 99 (70.2 %) of our study cases. Good compliance with the treatment was present in only 28 (19.9%) of our study cases. History of close contact with TB patient was reported by 92 (65.2%) of our study cases, 20 (14.2%) were defaulters and 42 (29.8%) presented with treatment failure. History of HIV infection was zero in our study. Conclusion; Previous history of Tuberculosis with poor compliance with drug therapy was the major risk factor for the development of MDR TB in our study. History of close contact with TB patients was another important risk factor in the development of MDR TB. Other important risk factors were previous history of tuberculosis infection, living in urban slum areas, poor educational status and poor socioeconomic status were more common.

Keywords; Multidrug resistance, Tuberculosis, Risk factors.