A Study of Epidemiological Pattern of Multidrug Resistant Pulmonary Tuberculosis Patients Presenting to a Tertiary Care Centre in Central India

Abstract

BACKGROUNDIn the present scenario, drug resistance is a huge obstacle in managing TB, as it is not only drug resistant, so difficult to treat, but also has huge financial and social burden. Objectives of the study are-1. To study the epidemiological pattern of pulmonary MDR-TB in central part of Madhya Pradesh. 2. To assess the risk factors for pulmonary MDR-TB. MATERIALS AND METHODS226 MDR-TB patients (with in-vitro resistance to rifampicin and isoniazid via line probe assay) presented to MY Hospital, Indore, were analysed over a period of one year of August 2015 to August 2016. This is a retrospective descriptive study. Analysis was done to know the epidemiological profile and assessment of risk factor for MDR-TB. RESULTS 63.3% patients were from age group 21 -40 years. 61.9% patients were male and 38.1% were female. In terms of socio-demographic profile, grand total of 72.2% (urban slums 49.6%, rural 22.6%) belonged to underdeveloped area, whereas rest belonged to urban areas. 5.8% (13) of total patients have positive family history, 10% (22) were HIV positive, 10.6% (24) were primary MDR patients, 15% (34) were treatment failure, 59.3% (134) treatment interrupted and 61.9% patients have mean body index between 10 -15 kg/m 2 (p value 0.163). CONCLUSIONAs young males are most commonly affected with MDR Tuberculosis, greater emphasis should be given on screening and treatment of young males. High percentages of patients were found to have low BMI. Awareness regarding proper nutrition and proper dietary supplements should be ensured since early adulthood. Health education and awareness program should be conducted in rural area and urban slums, as they form main source for the drug resistance TB. The bulk of patients are from treatment interrupted group, so strict compliance monitoring of all the patients on anti-tubercular treatment should be ensured. History of contact with MDR and PLHA are also independent risk factor for MDR-TB. KEYWORDSTuberculosis, MDR, LPA. HOW TO CITE THIS ARTICLE: Avashia S, Bansal D, Bhargava S, et al. A study of epidemiological pattern of multidrug resistant pulmonary tuberculosis patients presenting to a tertiary care centre in Central India. J. Evolution Med. Dent. Sci. 2018;7(08):962-964, DOI: 10.14260/jemds/2018/220 BACKGROUND MDR-TB is caused by strains of mycobacterium tuberculosis, resistant to both rifampicin and isoniazid with or without resistance to other drugs. 1 In present scenario drug resistant TB is a huge obstacle in managing tuberculosis, as it is not only difficult to treat but also has huge financial and social burden. In 2015, there were an estimated 480,000 new cases of multidrug-resistant TB (MDR-TB) and an additional 100,000 people with rifampicin-resistant TB (RR-TB) who 'Financial or Other Competing Interest': None. Submission 12-12-2017, Peer Review 01-02-2018, Acceptance 08-02-2018, Published 19-02-2018. Corresponding Author: Dr. Deepak Bansal, #11/2, Murai Mohalla, Sanyogitagani, Indore-452001, Madhya Pradesh. E-mail: drbansaldeepak@gmail.c...

Proportion and trend of primary resistance among Multidrug resistant Tuberculosis patients in Ethiopia

“…Regardless of the observed major bias of the study, the observed proportion of primary resistance among MDR/RR TB cases is higher than the studies in India [19] and Gondar University, Ethiopia [26] 10.6% and 13% respectively. The reason for the low proportion for the study in Ethiopia might be due to the high-risk categorization of patients for DST during the study period, or the misclassification bias mentioned above or the ongoing transmissions of MDR/RR TB might have increased the proportion of primary cases in the current study.…”

“…Although MDR TB doesn’t show significant association with HIV co-infection, most of the studies done reveal associations between Primary MDR TB and HIV co-infection in further analysis of the observed results [17] , [18] . Although studies show a higher proportion of MDR-TB among male patients [19] , [20] , female drug resistant TB patients are more likely to have primary DR-TB [21] .…”