Abstract
Background: Tuberculosis has been a major cause of suffering and death since times immemorial, thought to be one of the oldest human diseases. Drug resistance is a threat to TB control programs worldwide. One of the core factors in development of multi drug resistance is previous treatment received by the patient. Therefore we planned this study to find the various previous treatments correlates influencing development of drug resistance among MDR-TB patients
Objective:
1. To assess socio economic distribution of MDR cases reported at hospital
2. To find out association of previous treatment and its correlates with MDR cases reported at hospital
Method:It was a hospital based observational study. Informed consent of the patient was taken for the study. Approval from institutional ethical committee was obtained for the thesis. All information to accomplish objectives was collected by personal interview of each of the study subjects for about 30 to 45 minutes at PMDT site using pre-designed and pre-tested Proforma.
Results:MDR TB can affect all the age groups. In the study population, 214 (74.30%) patients were in the reproductive and economically productive age group of 16-45 years. The history of prior anti-tuberculosis medication was observed in 98.95% and it was strongly associated with development of MDR TB in our study.
Key words: MDR cases; previous treatment.
References
1. Rosenblatt MB. Pulmonary tuberculosis: evaluation of modern therapy. Bull NY Acad Med 1973; 49:163-96.
2. World Health Organization. Global tuberculosis control: WHO report 2012.WHO/HTM/TB/2012.6. Geneva, Switzerland; WHO 2012.http://www.who.int/tb.
3. Anonymous. Tuberculosis: a global emergency. World Health Forum 1993; 14:438.
4. Dye C. Global epidemiology of tuberculosis. Lancet 2006; 367 : 938-40.
5. Corbett EL, Watt CJ, Walker N, Maher D, Williams B, Raviglione MC, et al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemics. Arch Intern Med 2003; 163: 1009-21.
6. World Health Organization. Anti-tuberculosis drug resistance in the world; Report no. 4; WHO/HTM/TB/2008.394. Geneva, Switzerland: http://whqlibdoc.who.int/hq/2008.394.eng.pdf, accessed on April 5, 2010.
7. Multidrug resistant tuberculosis. ICMR. 1999; 29 (10 and 11):105-14.
8. Goble M, Iseman MD, Madsen LA, Waite D, Ackerson L, HorsburghJr CR. Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. N Engl J Med 1993; 328:527-32.
9. Mahmoud AMD, Michael D, Iseman MD. Pitfalls in the care of patients with tuberculosis: common errors and their association with the acquisition of drug resistance. AMA 1993; 270:65-8.
10. Pant R, Pandey KR, Joshi M, Sharma S, Pandey T, Pandey S: Risk Factor Assessment of Multidrug-Resistant Tuberculosis: J Nepal Health Res Counc 2009 Oct;7(15):89-92.
11. Bhatt G, Vyas S, Trivedi K. An epidemiological study of multidrug resistant tuberculosis cases registered under RNTCP of Ahmadabad city. Indian J Tuberc 2012; 59: 18-27.
12. Ruddy M, Balabanova Y, Graham C et al. Rates of drug resistance and risk factors analysis in civilian and prison patients with tuberculosis in Samara Region, Russia. Thorax. 2005 Feb; 60(2):130-5.
13. Choi JC, Lim SY, SuhGY,Chung MP, Kim H, Kwon OJ et al. Drug resistance rates of Mycobacterium tuberculosis at a private referral center in Korea. J Korean Med Sci 2007; 22:677–81.
14. Lee JH, Chang JH. Drug-resistant tuberculosis in a tertiary referral teaching hospital of Korea. Korean J Intern Med 2001; 16:173–9.
15. Granich RM, Oh P,LewisB,Porco TC, Flood J. Multidrug resistance among persons with tuberculosis in California, 1994-2003. JAMA 2005; 293:2732–2739.
16. Faustini A, Hall A, Perucci C. Risk factors for multidrug resistant tuberculosis in Europe: a systematic review. Thorax 2006;61: 158-63.
17. World Health Organization. Anti-tuberculosis drug resistance in the world. Third global report. The WHO/IUATLD Global Project on Anti-tuberculosis Drug Resistance Surveillance 1999–2002. WHO/HTM/TB/2004.343. Geneva, Switzerland: WHO, 2004.
18. Kliiman K, Altraja A Predictors of extensively drug resistant pulmonary tuberculosis Ann Intern Med 2009; 150:766-75.
19. Shao A, Yang D, Xu W, Lu W, Song H, Dai Y et al. Epidemiology of Anti-tuberculosis Drug Resistance in a Chinese Population: Current Situation and Challenges Ahead. BMC Public Health 2011; 11:110.
20. Barroso E C, SalaniMota R M, Oliveira Santos R O, Oliveira Sousa A L, BrasileiroBarroso J, Nobre Rodrigues J L. Risk factors for acquired multidrug-resistant tuberculosis. J Pneumol 2003; 29: 89–97.
21. Sharma S K and Mohan A 2003. Scientific basis of directly observed treatment, short course (DOTS); J. Indian Med. Assoc. 101:157–158,166.
22. Prasad R, Nautiyal RG, Ahuja RC et al. Treatment of new pulmonary tuberculosis patients: what do allopathic doctors do in India? Int J Tuberc Lung Dis 2002; 6:895-902.