scholarly journals PATTERNS OF SUSCEPTIBILITY TESTING OF ANTITUBERCULOSIS DRUGS AMONG PATIENTS ATTENDING TUBERCLOSIS CLINIC IN KAKAMEGA TEACHING AND REFERALL HOPITAL KENYA

2021 ◽  
Vol 9 (5) ◽  
pp. 902-905
Author(s):  
Kibai Erick K ◽  
◽  
Dinda Victor ◽  
Keyword(s):  
Drug Resistance ◽  
Statistical Tests ◽  
Cost Of Care ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Security Risk ◽  
First Line ◽  
Cross Sectional ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis

Drug Resistance Tuberculosis (DR TB) is a form of tuberculosis infection that is resistance to treatment with Rifampicin and Isoniazid with or without resistance to one or more other drugs used in the first line treatment of tuberculosis (Mitchison, 2012). Kenya is ranked 13th among the 22 high TB burden countries worldwide (WHO, 2013). MDR TB is a global health security risk and carries grave consequences for those affected (WHO, 2014). Its development is associated with high mortality rates and low levels of productivity among workers due to the high cost of care which imposes a heavy economic burden on the nation (Eduardo, 2011). DR TB therefore poses a major challenge to tuberculosis care and control (Ellen & McNerney, 2008). Limited literature talks about the exact prevalence of resistance to anti-tuberculosis drugs in populations with high rates of tuberculosis (WHO, 2015). In addition, only a few isolated cases of multiple drug resistant tuberculosis have been reported in Kenya (Ogaroet.al., 2012). This study aimed at determining the burden of pattern of Drug Restance TB via determination of the prevalence of TB and the gene resistance patterns to the two most commonly used anti- TB drugs Rifampicin and Isoniazid. A cross-sectional study was conducted among new and re-treatment cases of tuberculosis referral patients in Kakamega county teaching and referral hospital between June and August 2018. A total of 138 patients were enrolled for the study and the health facility TB register questionnaire was used to obtain data on demographic factors of the patients. Data generated was analyzed using the statistical package for social sciences (SPSS) version 22.0 to find case summaries. Descriptive statistical tests were performed on the data including means, modes, percentages, standard deviations and percentiles. Data was then presented in pie-charts, bar graphs and tables. Out of the 138 cases seventy (50.7%) were male and sixty-eight (49.3%) female. All the study cases were new. Twenty-eight (20.3%) of the isolates became positive for MTB. Of these, eight (5.7%) isolates showed resistance to either of the two first line drugs tested while twenty (14.5%) were fully susceptible. None of the isolates tested became positive for Drug resistant tuberculosis. Notably most of the resistant cases were found to be among HIV positive patients (4.3%) with (1.4%) of the cases being from HIV negative patients. This study revealed high levels of drug resistance among new cases of untreated patients. This implies ongoing transmission of drug resistant strains in the community.

scholarly journals First line anti-tubercular drug resistance among patients visiting German Nepal Tuberculosis Project, Nepal

2013 ◽  
Vol 2 (2) ◽  
pp. 45-48
Author(s):  
S Regmi ◽  
B Shrestha ◽  
A Katuwal
Keyword(s):  
Drug Resistance ◽  
Public Health Problem ◽  
Drug Susceptibility ◽  
Multidrug Resistant ◽  
Sputum Smear ◽  
Major Public Health Problem ◽  
Drug Resistant ◽  
First Line ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis

INTRODUCTION: Tuberculosis is one of the commonest causes of death in the world. It remains a major public health problem in developing countries including Nepal. Despite the reduction in incidence of tuberculosis by the implementation of anti-tuberculosis drugs regimen, TB remains pandemic due to emergence of drug resistant strain of M. tuberculosis. The aim of this study was to evaluate the first line anti-tubercular drug resistance among patients visiting German Nepal Tuberculosis Project, Nepal. MATERIALS AND METHODS: Anti-tubercular drug susceptibility test for first line drugs (Rifampicin, Isonizid, Ethambutol, and Streptomycin) was performed by proportion method (n=141) for new sputum smear positive patients attending German Nepal Tuberculosis Project, Kathmandu, Nepal. RESULTS: 78.1% (n=110.) were sensitive to all 4 drugs. Eight isolates (5.6%), 4(2.8%), 10(7.1%) and 31(21.9%) were resistant to any 4, 3, 2 and 1 drug respectively. Proportion of drug resistant (PDR) to one drug was 12.6%, two drugs 7.6%, three drugs (6.3%) and four drugs was 5.6%. Our result indicates the PDR to the first line drug was 21.9% and multidrug resistant (MDR) was 12 (8.5%). CONCLUSIONS: Drugs resistant cases of tuberculosis in increasing. Surveillance and monitoring of the drug resistant tuberculosis is necessary to prevent emergence of MDR, extensively drug resistant and so-called totally drug resistant tuberculosis.  DOI: http://dx.doi.org/10.3126/ijim.v2i2.8321   Int J Infect Microbiol 2013;2(2):45-48

scholarly journals Risk Factors and Treatment Outcome Analysis Associated with Second-Line Drug-Resistant Tuberculosis

2021 ◽  
Vol 2 (1) ◽  
pp. 1-12
Author(s):  
Muralidhar Aaina ◽  
Kaliyaperumal Venkatesh ◽  
Brammacharry Usharani ◽  
Muthukumar Anbazhagi ◽  
Gerard Rakesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Resistance ◽  
Drug Resistant ◽  
First Line ◽  
Drug Resistant Tuberculosis ◽  
Factors Associated ◽  
Resistant Tuberculosis ◽  
Increased Risk ◽  
Mdr Tb ◽  
Line Drug

The present study aimed at analyzing the treatment outcomes and risk factors associated with fluoroquinolone drug resistance having mutations in the gyrA and gyrB genes. A total of 258 pulmonary tuberculosis samples with first-line drug-resistant (H, R, or HR) were subjected to GenoType MTBDRsl assay for the molecular detection of mutations. Among the 258 samples, 251 were drug-resistant tuberculosis and seven were sensitive to all first-line TB drugs. Out of 251 DR-TB cases, 42 cases were MDR TB, 200 were INH mono-resistant and nine cases were RIF mono-resistant tuberculosis. Out of 251 DR-TB cases performed with a MTBDRsl assay, 14 had Pre-XDR-FQ, one patient had pre-XDR-SLID, one had extensively drug-resistant tuberculosis (XDR-TB) and 235 cases were sensitive to both FQ and SLID drugs. The study group had a mean average of 42.7 ± 16.4 years. The overall successful treatment outcomes among the MDR, INH mono-resistant, and pre-XRD patients were 70.6%, 82.0%, and 51%, respectively. The percentage of risk for the unfavorable outcomes in the pre-XDR, INH -mono-resistant, and XDR cases were 113.84% increased risk with RR 2.14; 95% CI 0.7821–5.8468. The independent risk factor associated with the unfavorable outcomes to failure was 77.78% increased risk with RR 1.78; 95% CI 0.3375–9.3655. Logistic regression analysis revealed that the percentage relative risk among MDR-TB patients for gender, male (RR: 1.85), age ≥ 61 years (RR: 1.96), and diabetics (RR: 1.05) were 84.62%, 95.83%, and 4.76%, respectively. The independent risk factors associated with INH mono-resistant cases of age 16–60 (RR: 1.86), ≥61 year (RR: 1.18), and treated cases (RR: 5.06). This study presaged the significant risk of INH mono-resistant, pre-XDR, and MDR among males, young adults, diabetics, and patients with previous treatment failure. Timely identification of high-risk patients will give pronounced advantages to control drug resistance tuberculosis diseases.

scholarly journals Risk factors for drug-resistant tuberculosis, the association between comorbidity status and drug-resistant patterns: a retrospective study of previously treated pulmonary tuberculosis in Shandong, China, during 2004–2019

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044349
Author(s):  
Ning-ning Tao ◽  
Yi-fan Li ◽  
Wan-mei Song ◽  
Jin-yue Liu ◽  
Qian-yun Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Resistance ◽  
Retrospective Study ◽  
Pulmonary Tuberculosis ◽  
Logistic Models ◽  
Smoking History ◽  
Categorical Variables ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis

ObjectiveThis study was designed to identify the risk factors for drug-resistant tuberculosis (DR-TB) and the association between comorbidity and drug resistance among retreated pulmonary tuberculosis (PTB).DesignA retrospective study was conducted among all the 36 monitoring sites in Shandong, China, over a 16-year period. Baseline characteristics were collected from the TB Surveillance System. Categorical variables were compared by Fisher’s exact or Pearson’s χ2 test. The risk factors for drug resistance were identified using univariable analysis and multivariable logistic models. The influence of comorbidity on different types of drug resistance was evaluated by performing multivariable logistic models with the covariates adjusted by age, sex, body mass index, drinking/smoking history and cavity.ResultsA total of 10 975 patients with PTB were recorded during 2004–2019, and of these 1924 retreated PTB were finally included. Among retreated PTB, 26.2% were DR-TB and 12.5% had comorbidity. Smoking (adjusted OR (aOR): 1.69, 95% CI 1.19 to 2.39), cavity (aOR: 1.55, 95% CI 1.22 to 1.97) and comorbidity (aOR: 1.44, 95% CI 1.02 to 2.02) were risk factors for DR-TB. Of 504 DR-TB, 9.5% had diabetes mellitus, followed by hypertension (2.0%) and chronic obstructive pulmonary disease (1.8%). Patients with retreated PTB with comorbidity were more likely to be older, have more bad habits (smoking, alcohol abuse) and have clinical symptoms (expectoration, haemoptysis, weight loss). Comorbidity was significantly associated with DR-TB (aOR: 1.44, 95% CI 1.02 to 2.02), overall rifampin resistance (aOR: 2.17, 95% CI 1.41 to 3.36), overall streptomycin resistance (aOR: 1.51, 95% CI 1.00 to 2.27) and multidrug resistance (aOR: 1.96, 95% CI 1.17 to 3.27) compared with pan-susceptible patients (p<0.05).ConclusionSmoking, cavity and comorbidity lead to an increased risk of drug resistance among retreated PTB. Strategies to improve the host’s health, including smoking cessation, screening and treatment of comorbidity, might contribute to the control of tuberculosis, especially DR-TB, in China.

scholarly journals Prevalence of primary drug resistant tuberculosis in a tertiary care hospital, Nepal

2015 ◽  
Vol 4 (4) ◽  
pp. 36-38
Author(s):  
R Khunjeli ◽  
U R Mohsin ◽  
S K Shrestha ◽  
S Adhikari ◽  
B Srivastava ◽  
...  
Keyword(s):  
Armed Forces ◽  
Care Hospital ◽  
Drug Resistant ◽  
Newly Diagnosed ◽  
First Line ◽  
Sensitivity Testing ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Resistant Strains ◽  
Primary Drug

 Background & objectives: Tuberculosis is a transmissible disease mainly due to inhalation of infected droplet nuclei. The burden of drug resistant tuberculosis is very high in our neighboring countries India and China. Prevalence of primary drug resistant disease is difficult to estimate in our country because culture and sensitivity is not done routinely. This study was an attempt to find out the prevalence of drug resistant in newly diagnosed tuberculosis patients serving in the Nepalese Armed Forces. Methodology: Medical records of patients serving in the Nepalese Armed Forces who had the provisional diagnosis of pulmonary tuberculosis for the first time from July 2012 to June 2014 were analyzed. They had their sputum subjected for both smear and culture with sensitivity testing. Out of 134 patients, 62 had culture positive for Mycobacterium tuberculosis and drug sensitivity was done for the first line 4 antitubercular drugs. Results: Drug resistant strains were found in 5 cases (8.1%) of which 2 (3.2%) were resistant to 4 first line drugs - rifampicin, isoniazid, ethambutol and streptomycin. Prevalence of isoniazid resistance was the highest, found in 3 cases (4.8%). Conclusion: Primary drug resistant tuberculosis in newly diagnosed cases was high even in young healthy adults, and isoniazid resistant strains were the commonest.DOI: http://dx.doi.org/10.3126/jcmc.v4i4.11970

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