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Factors contributing to development of multidrug resistant tuberculosis

Amit M Shah, Rima B Shah, Pranjal N Dave.




Abstract

Background: Several factors have been identified in the causation of multidrug-resistant tuberculosis (MDR-TB). The most important is previous inadequate treatment. Other factors include coinfection with HIV, diabetes mellitus, socioeconomically deprived groups, intravenous drug abusers, and other immunocompromised states. This study was planned to find out contributing/associated factors for the development of MDR-TB, specifically patients related factors.

Aims and Objectives: The present study was conducted among MDR-TB patients to get the information regarding sociodemographic profile, present and history of TB, problems faced during treatment, and drug resistance pattern.

Materials and Methods: A prospective, cross-sectional study was undertaken in a tertiary care teaching hospital. A total of 50 cases were included in the study who fulfilled inclusion criteria. All information was collected by studying the patients’ treatment record and by personal interview of each of the study participants using case record form.

Results: Middle age groups (21–30 years and 31–40 years) were most commonly affected with MDR-TB. It was found that 44% of patients were smoker, 34% of patients were alcoholic, and 36% of patients were addicted to tobacco chewing, and 96% of patients have a body mass index below the normal range. Most of the patients were from lower socioeconomic status - Class V followed by class. Most of the patients (44) are of secondary MDR-TB and while only 6 patients are of primary MDR-TB.. Out of 44 secondary cases of MDR-TB total, 16 cases are due to not completion of the treatment, the reasons were poor adherence, adverse drug reactions, and substance abuse, etc., four patients were living with HIV/AIDS, and 3 patients were suffering from diabetes mellitus.

Conclusion: There are causative factors and several risk factors associated with the development of MDR-TB has been found in the study. The strategy must be planned for incorporation of these factors in deciding treatment of MDR-TB.

Key words: Factors; Tuberculosis; Multidrug-Resistant; Association






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