Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance

Conaty, Stephen; Hayward, Andrew; Story, Alistair; Glynn, Judith R.; Drobniewski, Francis; Watson, John M.

doi:10.1017/s0950268804002869

Cited by 19 publications

(21 citation statements)

References 22 publications

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“…A high bacterial load by AFB smear was considered if more than three AFB smears are positive. These findings were supported by other studies [12,32,33]. The positive smear carried the risk of transmission of the infection.…”

Section: Discussionsupporting

confidence: 86%

Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study

Elmi

Hasan

Abdullah

et al. 2015

J Infect Dev Ctries

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Introduction: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a major clinical public health threat and challenges the national TB control program in Malaysia. Data that elaborates on the risk factors associated with the development of MDR-TB is highly limited in this country. This study was aimed to determine the risk factors associated with the development of MDR-TB patients in peninsular Malaysia. Methodology: This was a case control study; the data were collected from medical records of all the registered MDR-TB patients at five referral TB hospitals in peninsular Malaysia from January 2010 to April 2014. The 105 cases were all confirmed by a positive sputum culture of Mycobacterium tuberculosis for MDR-TB and extensively drug-resistant (XDR)-TB. As a comparison, a total of 209 non-MDR-TB cases were randomly selected as controls. Results: A total of 105 MDR-TB and 209 non MDR-TB patients were studied. The risk factors associated with MDR-TB within the multivariate analysis were previous tuberculosis treatment, HIV infection, being an immigrant, and high load of positive for acid-fast bacillus (AFB) smear. Conclusions: The findings of this study revealed that patients who had received previous treatment for tuberculosis, were infected with HIV, were immigrants, and had a high burden of positive testing for AFB smear were more likely to have MDR-TB. An enhanced understanding of the risk factors associated with MDR-TB strains is imperative in the development of a national policy for public health interventions.

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Section: Discussionsupporting

confidence: 86%

Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study

Elmi

Hasan

Abdullah

et al. 2015

J Infect Dev Ctries

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“…In contrast to previous studies from the UK and some other Western countries [12][13][14][15][16][17][18][23][24][25], this large, up-to-date study provides little evidence that HIV co-infected patients are at increased risk of drug-resistant tuberculosis. Among cases with a previous tuberculosis diagnosis, there was no evidence of an association, although numbers were small.…”

Section: Discussioncontrasting

confidence: 61%

“…In the present study, there was no overall association between HIV and initial multidrug resistance after adjusting for confounding factors. An earlier UK study [25], as well as several studies in Western Europe [15][16][17], found an association between HIV and initial multidrug-resistant tuberculosis. The reason for the differing finding in the present study could be related to the different time periods studied, lack of adjustment for confounders in previous studies [17], or possibly the differing demographics of tuberculosis cases.…”

Section: Discussionmentioning

confidence: 90%

“…Earlier studies in the UK have found an increased risk of isoniazid resistance among HIV-positive cases during the 1990s [23,24] but, because these studies did not analyse new and previously diagnosed cases separately, it is difficult to compare the results with those of the present study. CONATY et al [25] found an increased risk of initial isoniazid resistance among HIV-positive patients in England and Wales during 1993-1994 but no association in 1999-2000. An outbreak of isoniazid-resistant tuberculosis began in 1999-2000 [28] and has not been associated with HIV infection.…”

Section: Discussionmentioning

confidence: 99%

“…Two earlier studies in the UK have found that, during the early to mid-1990s, HIV-positive patients were more likely to have isoniazid and multidrug resistance, but these studies were based on univariable analysis only and did not separate new and previously diagnosed cases [23,24]. CONATY et al [25] found an increased risk of initial isoniazid resistance among HIV-positive patients during the period 1993-1994 but no association during 1999-2000, and an association with initial multidrug resistance in the combined periods. There was no evidence of any association between HIV and acquired drug resistance.…”

mentioning

confidence: 99%

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The association between HIV and antituberculosis drug resistance

French¹,

Glynn²,

Kruijshaar³

et al. 2008

European Respiratory Journal

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In the UK, HIV is considered to be a risk factor for antituberculosis drug resistance. Evidence of the association is, however, inconclusive and there are few population-level data. The present study investigated the association in England and Wales during the period 1999-2005.National tuberculosis surveillance data for adults were matched to HIV/AIDS reports. Unmatched cases were assumed to be HIV-negative. Separate analyses were conducted on new tuberculosis cases and those with a previous diagnosis. Logistic regression was used for univariable and multivariable analyses.There were 1,657 previously diagnosed cases (80 HIV-positive) and 18,130 new cases (1,156 HIV-positive). Isoniazid resistance was found in 8.1% of previously diagnosed cases and 6.6% of new cases, and multidrug resistance in 2.8% and 0.7%, respectively. There was no evidence of an association between HIV and antituberculosis drug resistance among previously diagnosed cases. Among new cases, there was no overall association between HIV and isoniazid or multidrug resistance after adjusting for confounding factors. White HIV-positive patients were more likely to have multidrug resistance, but numbers were small. In contrast to some previous studies, this large, up-to-date study provides little evidence that HIV co-infected tuberculosis patients in England and Wales are at increased risk of firstline antituberculosis drug resistance.

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Previous treatment in predicting drug-resistant tuberculosis in an area bordering East London, UK

Melzer

Gupta

Petersen

et al. 2010

International Journal of Infectious Diseases

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Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance

Cited by 19 publications

References 22 publications

Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study

Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study

The association between HIV and antituberculosis drug resistance

Previous treatment in predicting drug-resistant tuberculosis in an area bordering East London, UK

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