Antitubercular Drug Resistance in Four Healthcare Facilities in North India

Gupta, Anamika; Mathuria, Jitendra Prasad; Singh, Surya Kumar; Gulati, Anil Kumar; Anupurba, Shampa

doi:10.3329/jhpn.v29i6.9895

Cited by 20 publications

(20 citation statements)

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“…The prevalence of rifampicin-resistant M. tuberculosis in this study was in keeping with previous studies in Nigeria [28], North India [29], Iran [30] and Northeast China [25]. However, it was higher than studies observed in Ethiopia [8, 9, 31, 32], Kenya [33], Nigeria [34], Uganda [35] and South of Iraq [36].…”

Section: Discussionsupporting

confidence: 89%

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

et al. 2017

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BackgroundPrevailing data on rifampicin-resistant M. tuberculosis is essential for early management of MDR-TB. Therefore, this study was conducted to determine the prevalence of rifampicin-resistant Mycobacterium tuberculosis and associated factors among presumptive TB cases in Debre Markos Referral Hospital, Ethiopia.MethodsA cross-sectional study was conducted from September 2014 to March 2015. Detection of M. tuberculosis and resistance to rifampicin was performed using Gene Xpert MTB/RIF assay. Data was collected using structured questionnaire by face to face interview. Logistic regression analysis was computed to determine the associated factors of rifampicin-resistant M. tuberculosis.ResultsA total of 505 presumptive TB patients included in the study. The prevalence of M. tuberculosis confirmed cases was 117 (23.2%) (95% CI 19.7–27%). It was higher among males (27.9%) than females (17.9%) (AOR: 2.17; CI 1.35–3.49). Of the 117 M. tuberculosis confirmed cases, 12 (10.3%) (95% CI 6.0–17.1%) were resistant to rifampicin. Rifampicin-resistant M. tuberculosis was noticed in 7 previously treated TB patients (17.1%) and 5 treatment naive patients (6.7%) (AOR: 4.16; CI 1.04–16.63). The prevalence of rifampicin-resistant M. tuberculosis was 6 (9.8%) and 6 (11.3%) in pulmonary and extra-pulmonary infections, respectively. Of the 30, MTB/HIV co-infection, 3 (10%) were rifampicin-resistant M. tuberculosis.ConclusionRifampicin-resistant M. tuberculosis is prevalent in both pulmonary and extra-pulmonary tuberculosis patients. Previous treatment with anti-TB drugs was significantly associated with rifampicin resistance. Therefore, the use of Gene Xpert should be scaled up across the country for rapid detection and management of drug resistant M. tuberculosis.

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Section: Discussionsupporting

confidence: 89%

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

et al. 2017

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“…According to our study, we found 132 (9.1%) of rifampicin-resistant cases among con rmed TB cases. This result is comparable with studies conducted in Debre Markos Referral Hospital (10.3%) [13], Felege Hiwot Referral Hospital and Debre Tabor Hospital (9.3%) [20], Addis Ababa (9.9 %) [48] and India (10.5%) [38].Our nds are higher than studies conducted on northwest, east and south parts of Ethiopia (2.9%-5.7%) [6,19,31-32,39,42,46 and 48], Nigeria (2.9%) [24] and Zambia (5.9%) [33].The possible explanation for these variations could be related to our retrospective approach spanning four years, or differences in study designs .However, our incidence was lower than for studies conducted in Gondar 15.8% [14],other parts of Ethiopia (11.5-39.4) [39-40and 51],Congo (42.2%) [47] and China (17.6-26.3%) [43 and 50].…”

Section: Discussionsupporting

confidence: 87%

Trends of Mycobacterium Tuberculosis and rifampicin resistance in Adigrat General Hospital, Eastern Zone of Tigrai, North Ethiopia

Abay

Hailay

2020

Preprint

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Background: Tuberculosis is an infectious disease usually caused by Mycobacterium tuberculosis bacteria. The global emergence of mono- or multidrug-resistant tuberculosis and extensively drug-resistant forms of tuberculosis pose a considerable challenge to tuberculosis control programs. There has been no reliable and organized data on trends and drug resistance of Mycobacterium tuberculosis in the study area. Therefore, this study aimed to determine the trends of Mycobacterium tuberculosis and rifampicin resistance in the Adigrat General Hospital, eastern Zone of Tigrai, North Ethiopia.Methods: A hospital-based retrospective cross-sectional study was conducted at Adigrat General Hospital from January 2015 to 2018.Data was collected retrospectively from the GeneXpertTM TB registration book using a data extraction format. Data was entered into Epi-Info 3.1 and subsequently exported and analyzed using SPSS Version 20.The results were summarized using descriptive statistics, tables, and figures. Bivariate and multi-variant regression analysis was employed to measure the association between dependent and independent variables. P values < 0.05 were considered statistically significant.Result: A total of 5,944 Mycobacterium tuberculosis presumptive patients were included in the study. The majority of the study participants were male (58.1%) with participants’ median age of 40.0 (IQR 26-57) years, the majority were 30-44 years. The overall positive cases of Mycobacterium tuberculosis was 24.3% (1446) with a total of 132 (9.1%) found to be resistant to rifampicin. Of the total confirmed positive cases 8.7 % (103/1188) and 11.2 % (29/258) were rifampicin resistance of presumptive tuberculosis and presumptive drug resistance tuberculosis patients respectively. Age, the reason for diagnosis, site of presumptive tuberculosis, and/or being HIV infected showed significant association with our dependent variable; however, only age and being HIV infected were associated with rifampicin resistance.Conclusion: In our study, the overall trends of Mycobacterium tuberculosis and rifampicin resistance were found to be high. Rifampicin resistance is more common in patients with HIV and presumptive drug resistance tuberculosis individuals. Therefore, maximizing early detection of drug-resistant and strengthening tuberculosis infection control activities are recommended to reduce the burden of this contagious and potentially deadly disease.

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“…treated PTB patients2238.120.2LJTertiary hospital16Mishra J K et al, 2009 [61]Varanasi2007–2009Combined PTB patients5121.626.511.8Not specifiedTertiary hospital17Porwal C et al, 2013 [28]Delhi2007–2010Prev. treated PTB patients60979.379.38.767.932.13.0MGIT 960Tertiary hospital18Sharma S K et al (c), 2011 [62]Delhi2008–2009Newly diagnosed PTB patients1771.71.11.1LJPrimary healthcare19Yadav R et al, 2013 [63]Chandigarh2008–2010Combined PTB patients17148.55.91.24.714.017.033.35.9LJTertiary hospital20Gupta A et al (a), 2011 [64]Varanasi2008–2010Combined PTB patients28857.635.8LJTertiary hospital21Sagar T et al, 2013 [65]Delhi2009–2010Combined PTB patients365.62.82.8LJTertiary hospital22Singh N et al, 2014 [66]Delhi2009–2012Pre...…”

Section: Resultsmentioning

confidence: 99%

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

et al. 2017

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BackgroundDrug-resistant pulmonary tuberculosis (DR-TB) is a significant public health issue that considerably deters the ongoing TB control efforts in India. The purpose of this review was to investigate the prevalence of DR-TB and understand the regional variation in resistance pattern across India from 1995 to 2015, based on a large body of published epidemiological studies.MethodsA systematic review of published studies reporting prevalence of DR-TB from biomedical databases (PubMed and IndMed) was conducted. Meta-analysis was performed using random effects model and the pooled prevalence estimate (95% confidence interval [CI]) of DR-TB, multidrug resistant (MDR-) TB, pre-extensively drug-resistant (pre-XDR) TB and XDR-TB were calculated across two study periods (decade 1: 1995 to 2005; decade 2: 2006 to 2015), countrywide and in different regions. Heterogeneity in this meta-analysis was assessed using I2 statistic.ResultsA total of 75 of 635 screened studies that fulfilled the inclusion criteria were selected. Over 40% of 45,076 isolates suspected for resistance to any first-line anti-TB drugs tested positive. Comparative analysis revealed a worsening trend in DR-TB between the two study decades (decade 1: 37.7% [95% CI = 29.0; 46.4], n = 25 vs decade 2: 46.1% [95% CI = 39.0; 53.2], n = 36). The pooled estimate of MDR-TB resistance was higher in previously treated patients (decade 1: 29.8% [95% CI = 20.7; 39.0], n = 13; decade 2: 35.8% [95% CI = 29.2; 42.4], n = 24) as compared with the newly diagnosed cases (decade 1: 4.1% [95% CI = 2.7; 5.6], n = 13; decade 2: 5.6% [95% CI = 3.8; 7.4], n = 17). Overall, studies from Western states of India reported highest prevalence of DR-TB (57.8% [95% CI = 37.4; 78.2], n = 6) and MDR-TB (39.9% [95% CI = 21.7; 58.0], n = 6) during decade 2. Prevalence of pre-XDR TB was 7.9% (95% CI = 4.4; 11.4, n = 5) with resistance to fluoroquinolone (66.3% [95% CI = 58.2; 74.4], n = 5) being the highest. The prevalence of XDR-TB was 1.9% (95% CI = 1.2; 2.6, n = 14) over the 20-year period.ConclusionThe alarming increase in the trend of anti-TB drug resistance in India warrants the need for a structured nationwide surveillance to assist the National TB Control Program in strengthening treatment strategies for improved outcomes.

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Antitubercular Drug Resistance in Four Healthcare Facilities in North India

Cited by 20 publications

References 20 publications

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

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

Trends of Mycobacterium Tuberculosis and rifampicin resistance in Adigrat General Hospital, Eastern Zone of Tigrai, North Ethiopia

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

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