Abstract
Background: Tuberculosis (TB) is a chronic infectious disease that has afflicted mankind for 5000 years. It has caused more deaths in adults than any other infectious disease The emergence of multidrug-resistant (MDR) TB has introduced challenging, but surmountable, complexities to TB programs, MDR-TB remains a public health crisis and a health security threat.. XDR-TB is more expensive and difficult to treat than MDR-TB and outcomes much worse with higher rates of treatment failure and death. Therefore we planned this study to analyze the various clinico socio demographic factors associated with the development of XDR-TB among MDR-TB patients
Objective
- To assess the various clinico socio demographic status of MDR cases
- To identify the associated factors for the conversion of MDR to XDR tuberculosis.
- To estimate the conversion rate of XDR tuberculosis from MDR tuberculosis
Method: It was a hospital based observational and prospective study. Informed consent of the patient was taken for the study. All information to accomplish objectives was collected by personal interview of each of the study subjects for about 30 to 45 minutes at PMDT site using pre-designed and pre-tested Proforma.
Results: Among the study participants 66.5%(125) were males and 33.5%(63) were females. Among males 16.8% (21) got converted to XDR while among the females 33.3%(21) converted to XDR tuberculosis. In the study 39.9% (75) were living in houses without overcrowding and 60.1%(113) were living in houses with overcrowding. . Among those living in overcrowded houses 14.7%(11) converted to XDR. In those who didn’t live in overcrowded houses 27.4%(31) converted to XDR.
Keywords: MDR-TB ,XDR-TB, clinico socio demographic impact, associated factors, conversion rate.
References
- World Health Organization. Global tuberculosis report, 2018. WHO/HTM/ TB/2018.11. Geneva, Switzerland: WHO, 2018.
- Extensively drug-resistant tuberculosis (XDR-TB): recommendations for prevention and control. Weekly Epidemiol Rec 2006; 81: 430–432
- F. Gallo, J.M.W. Pinhata, V. Simonsen, V.M.N. Galesi, L. Ferrazoli, R.S. Oliveira, Prevalence, associated factors, outcomes and transmission of extensively drug-resistant tuberculosis among multidrug-resistant tuberculosis patients in Sa~o Paulo, Brazil: a cross-sectional study, Clinical Microbiology and Infection 2018;24:E889e895.
- Christie Y. Jeon, A Soo Hee Hwang, A Jin Hong Min, D. Rebecca Prevots, Lisa C. Goldfeder, Hyeyoung Lee, Seok Yong Eum, Doo Soo Jeon, Hyung Seok Kang, Jin Hee Kim, Byoung Ju Kim, Dae Yeon Kim, Steven M. Holland,Seung Kyu Park, Sang Nae Cho, Clifton E. Barry, 3rd, and Laura E. Via. Extensively Drug-Resistant Tuberculosis in South Korea: Risk Factors and Treatment Outcomes among Patients at a Tertiary Referral Hospital. Clinical Infectious Diseases 2008;46:42-9.
- Dalton T, Cegielski P, Akkisilip S, Asencios L, Campos Caoili J, Cho SN et al. Prevalence of and risk factors for resistance to second line drugs in people with multidrug-resistant tuberculosis in eight countries: a prospective cohort study. Lancet 2012;380:1406-17.
- Matteeli A, Roggi A, Carvalho ACC. Extensively drug-resistant tuberculosis: epidemiology and management. Clin Epidemiol 2014;6:111-8.
- Thorson A, Johansson E. Equality or equity in health care access: a qualitative study of doctor explanation to a longer delay among female TB patients in Vietnam. Health Policy 2004;68:37-46.
- Shenjie Tang, Shouyong Tan, Lan Yao, Fujian Li, Li Li, Xinzhi Guo, Yidian Liu, Xiaohui Hao, Yanqiong Li, Xiuxiu Ding, Zhanjun Zhang, Li Tong, Jianan Huang. Risk Factors for Poor Treatment Outcomes in Patients with MDR-TB and XDR-TB in China: Retrospective Multi Center Investigation. PLOS ONE December 2013; 8(12):E82943.
- O’Donnell MR, Zelnick J, Wermer L, Master I, Loveday et al. Extensively drug resistant tuberculosis in women, KwaZulu-Natal, South Africa. Emerg Infect Dis 2011;17(10):1942-1945.
- Abubakat I, Zignol M, Falzon D, Raviglione M, Ditiu L, Masham S, et al. Drug-resistant tuberculosis time for visionary political leadership, Lancet Infect Dis 2013;13:529-39.
- Yanina Balabanova, Birute Radiulyte, Edita Davidaviciene, Richard Hooper, Olga Ignatyeva, Vladyslav Nikolayevskyy and Francis A. Drobniewsk. Risk factors for drug-resistant tuberculosis patients in Lithuania, 2002–2008. Euro Respair J 2010;39(5):1266-1269.
- Chhavi porwal, Amit Kaushik, Nayani Makkar, Jayant N. Banavaliker, Mahumud Hanif, Rupak Singla, Anuj K. Bhatnagat, Digambar Behera, Jitendra Nath Pande, Urvashi B. Singh. Incidence and Risk factors for extensively drug resistant tuberculosis in delhi region. PLOS ONE 2013;8:e55299
- Myneedu VP, Visalakshi P, Verma AK, Behera D, Bhalla M, prevalence of XDR TB cases – a retrospective study from a tertiary care TB hospital. Indian J Tuberc 2011;58(2):54-9.
- Mondal R, Jain A, Extensively drug-resistant Mycobacterium tuberculosis, India. Emer Infectious Dis 2007;13(9):1429-31.
- Ajbani K, Rodrigues C, Shenai S, Mehta A, Can mutation detection accurately predict XDR-TB: Study from a tertiary care centre India. J Clin Microbiol 2011;49(4):1588-90.
- Sameer A, Unnati D, Desai, Jyotsna M, Joshi. Prevalance of pre-extensively drug-resistant tuberculosis (pre XDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) among pulmonary multi drug-resistant tuberculosis (MDR-TB) at a tertiary care centre in Mumbai. Journal of Krishna institute of medical sciences university 2016;5(3):13-19.
- Singh S, Sankar MM, Gopinath K. High rate of extensively drug-reisitant tuberculosis in Indian AIDS patients. AIIDS 2007;21(7):2345-
- Thomas A, Ramachandran R, Rehaman F, Jaggarajamma K, Santha T, Selvakumar N et al. Management of multidrug-resistant tuberculosis in the field: Tuberculosis research centre experience. Indian J Tuberc 2007;54:117-24.
Corresponding Author
Dr S.Hariharan
Junior Resident, Dept of Tuberculosis & Respiratory Medicine SN Medical College, Agra
DOI: https://dx.doi.org/10.18535/jmscr/v8i6.78
