Socio-Demographic and Clinical Profile of Drug Resistant Tuberculosis Patients in a Tertiary Care Centre of Kolkata

Abstract

Background: Drug resistant tuberculosis is a major public health threat that hinders progress in tuberculosis control worldwide. In 2019, India contributed highest cases of TB (27%) Worldwide. In 2019, 3.3% of new TB cases and 18% of previously treated cases had MDR/RRTB worldwide and India (27%) had the largest share of the global burden. This study was done to find out the sociodemographic and clinical profile of drug resistant TB patients. Methodology: It is an observational descriptive study with cross-sectional design, conducted at the drug resistant tuberculosis centre of R. G. Kar Medical College of Kolkata, West Bengal. Study Population consisted of the patients who were registered for the DR-TB regimen. Study duration was July 2016 –March 2017. Pre-tested, semi-structured schedule was designed to capture their sociodemographic profile, treatment history, clinical findings and available medical records. Data were compiled in MS Excel and analyzed in IBM SPSS 23.0. Results: Out of 159 cases, 27% patients were between 21-30 years. Males were predominant (68.6%). Most patients (56.6%) were underweight (BMI<18.5kg/m2). HIV seropositivity was found in 4 (2.5%) cases. Among all cases, 81.1% had history of taking ATD and 34.4% was cured in previous episode of treatment. The commonest associated comorbidity was DM (15.7%). Rifampicin resistance (93.1%) was most common followed by Isoniazid (8.2%). Pallor was found among 94.3% patients. Most patients had bilateral (62.3%) and moderately extensive (57.2%) lesions in chest x-ray. Conclusion: DR-TB control should focus adequately on younger age group as numbers of resistance is increasing among them. Relapse in previously cured cases was found to be major contributor of DR-TB suspect cases. Though, Rifampicin resistance was so common but prevalence of resistance to 2nd line drugs is still low. Focus should be given on early detection of drug resistance in all TB cases and improvement of nutritional status of the TB patient.

Observation Study among Cured Cases of Pulmonary Tuberculosis: A Long-Term Study under the Revised National Tuberculosis Control Program

“…The most common form of substance use was smoking 2 (27%), followed by alcohol 27 (26%), with duration of more than 5 years was most common among study participants. Similar findings were observed by Mukherjee et al (2015) and Basu et al (2021) found that history of smoking (28%), and alcohol intake (28%) were present. Out of 527 cases tracking in this study, 103 (19.5%) developed the symptoms suggestive of TB.…”

“…it is not known whether the patient's body was completely eliminated (eradication) from Tuberculosis. In previous studies (Mathur et al, 2019;Sharma et al, 2019;Basu et al, 2021), pointed to factors contributing to the reactivation of the tuberculosis process, which may be facilitated by labour migration with the likelihood of superinfection with another strain of mycobacterium TB. Despite the repeated visits, this study could not track more than onefourth (213) of cases mainly due to the incomplete or wrong address, migration or death due to some unknown diagnosis.…”

Treatment outcome of drug-resistant tuberculosis (DR-TB) following uptake of universal drug susceptibility testing: A record review from a nodal DR-TB center

“…MDR: Multidrug resistant, XDR: Extensively drug resistant not accessible 20. Moreover, another study by Mulisa et al, reported an extremely high unfavorable treatment outcome rate (81%), due to driven factors such as behavioral factors like alcoholism, chat chewing, then concurrent chronic disease, previous history of tuberculosis, and irrational antacid use for gastritis while being treated for tuberculosis.…”