Resistance to Isoniazid and Rifampicin and Factors Associated with Resistance Among MDR TB Patients Visiting DOTS PLUS Site
Journal Title: MVP Journal of Medical Sciences - Year 2017, Vol 4, Issue 1
Abstract
Introduction: Multidrug-Resistant (MDR-TB) is defined as M tuberculosis resistant to isoniazid and rifampicin with or without resistant to other drugs. Drug resistant TB is known to occur from time of introduction of antituberculosis drugs. MDR TB has become a significant health problem and an obstacle to effective TB control1. Resistance of M. tuberculosis to anti- TB drugs is caused by chromosomal mutations in genes encoding drug targets. Multidrug-resistant strains of M. tuberculosis (MDR-TB) evolve due to sequential accumulation of mutations in target genes. The WHO cites TB as the single most important fatal infection, with around 8.8 million new cases and 1.4 millions deaths per year, 95% in developing countries. According to Global TB report 2015 data of MDR TB as follows2. 50% successfully completed treatment (cure or treatment completed), 16% died, 16% defaulters, 10% treatment failure, 8% without outcome. The MDR-TB is also threatening World Health Organization’s target of tuberculosis elimination by 2050. Study conducted by NIRT and NTI suggest MDR level of 1% to 3% in new cases and around 12% in retreatment cases and revealed an overall emergence to rifampicin in only 2% of patients, despite a high level (18%) of initial resistance to isoniazid, either alone in or in combination with other anti tuberculosis drugs+. Aims and Objectives: 1. To Study the drug resistance to isoniazid and rifampicin among the MDR TB patients visiting DOTS PLUS CENTRE. 2. To Study the various factors associated with resistance to Isoniazid and rifampicin among MDR TB patients. Material and Methods: Present study was conducted at DOTS PLUS Centre in tertiary health care centre. Total 140 of newly diagnosed cases of MDR-TB were included in the present study after satisfying the inclusion and exclusion criteria. Written informed consent was taken from the study participants. Patients’demographic details were noted such as name, age, sex, occupation, socioeconomic status, education. Patients were asked detailed history about smoking, alcohol, tobacco chewing, diabetes mellitus, hypertension, COPD (chronic obstructive pulmonary disease), HIV Status. Details about past history of tuberculosis, treatment history were noted, If the patient was found to have defaulted previous antituberculous treatment, detailed evaluation was done to find out reasons for defaulting the treatment, History of MDR TB contact was noted. The drug resistance pattern of isoniazid and rifampicin was noted. Results: Of the 140 drug resistance tuberculosis patients, MDR Pulmonary tuberculosis was more common in economically productive age group of 21-40 years, distribution of male (60%) and female (40%), 35% patients were found to have defaulted previous antituberculous treatment. Main reasons for defaulting were, becoming asymptomatic, feeling better 40.8% followed by medication side effects 32.65% Conclusion: Isoniazid and rifampicin resistance (74.28%)is more than rifampicin monoresistance (25.72%), there is significant association between addiction of patient and defaulting the previous antituberculous treatment, analysis of patients various factors for drug resistance showed that MDR-TB is more commonly seen in males, age between 21 to 40 years, low socioeconomic status, past history of ATT, Alcoholic and tobacco user.
Authors and Affiliations
Gauri Suhas Kulkarni, Chetan Mahajan
Keywords
Related Articles
- EP ID EP430709
- DOI 10.18311/mvpjms/2017/v4i1/14782
- Views 101
- Downloads 0
Histopathological Findings in Uterus and Cervix of Hysterectomy Specimens
Background: For centuries, the female reproductive system has been affected by various abnormalities and diseases and hence has been the subject of interest and the basis for the gynaecological practice. The uterus being...
Clinical Profile and Management of Patients Admitted with Acute Kidney Injury Secondary to Gastroenteritis in a Tertiary Care Teaching Hospital
Aim: To study clinical profile, laboratory features and importance of rehydration in patients admitted with acute kidney injury due to gastroenteritis. Materials and Methods: The study was carried out as a prospective ob...
Comparative Assessment of Severity of Dyselectrolytaemia (Sodium and Potassium) in Cerebral Infarction and Cerebral Hemorrhage
Aim: 1) To compare serum electrolyte levels (sodium and potassium levels) in cerebral Infarction and cerebral hemorrhage. 2) To compare serum electrolytes in thalamic and other intracranial hemorrhages. Material and Meth...
A Study of Limbal Conjunctival Autograft Transplantation in Primary Pterygium
Aim: To study limbal conjunctival autograft transplantation in primary pterygium. Material and Methods: The present study was conducted on 100 eyes of 100 patients with primary pterygium attending the outpatient departme...
A Clinical Study Comparing Different Techniques of Nucleus Delivery in Manual Small Incision Cataract Surgery
Aim: To compare different technique of nucleus delivery in small manual incision cataract surgery,regarding their safety and intra operative complication. Material & Methods: A total of 285 patients with cataract undergo...