An analysis of risk factors for Multidrug Resistant Tuberculosis (MDR-TB): a hospital-based study 10.55131/jphd/2023/210208
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Abstract
Multidrug Resistant Tuberculosis (MDR-TB) is the world's most serious problem and one of the leading causes of death. Because of its difficult diagnosis, high rates of treatment failure, and death, MDR-TB is a new challenge in TB control programs. The study aims to identify and analyze the risk factors of Multidrug Resistant Tuberculosis (MDR-TB). The study used a case control study design and was conducted at the Labuang Baji Hospital in Makassar City, Indonesia. The sample was 140 people consisting of 70 in the case group and 70 in the control group. Purposive sampling was used to collect the data. Data were analyzed using STATA program with Multiple Logistic Regression. Significant risk factors of Multidrug Resistant Tuberculosis (MDR-TB) were duration of treatment (OR= 5.655 [Cl 95%: 2.507-12.999]; p<0.001), previous treatment history (OR= 4.833 [Cl 95%: 2.092-11.525]; p<0.001), PMO factor (OR= 3.106 [Cl 95%: 1.227-8.338]; p=0.008), compliance with drugs (OR= 10.961 [Cl 95%: 4.640-26.40]; p<0.001), drug side effects (OR=2.521 [Cl 95%: 1.070-6.126]; p=0.020) and protective factor is the complexity of drug regimen (OR= 0.329 [Cl 95%: 0.136-0.768]; p=0.005). It can be concluded that compliance with drugs is a dominant risk factor for MDR-TB. Improved TB control programs by monitoring the treatment of patients who experienced treatment failure (dropout) probably will increase treatment adherence and cut off MDR-TB transmission.
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References
Workicho A, Kassahun W, Alemseged F. Risk factors for multidrug-resistant tuberculosis among tuberculosis patients: a case-control study. Infect Drug Resist. 2017;10:91-6. doi: 10.2147/IDR.S126274.
World Health Organization. Global tuberculosis: Perspectives, prospects, and priorities. [Internet]. [Cited 2022 May 17]. Availlable from: https://www. https://www.who.int/publications/digital/global-tuberculosis-report-2021
Iradukunda A, Ndayishimiye GP, Sinarinzi D, Odjidja EN, Ntakaburimvo N, Nshimirimana I, et al. Key factors influencing multidrug-resistant tuberculosis in patients under anti-tuberculosis treatment in two centres in Burundi: a mixed effect modelling study. BMC Public Health. 2021;21(1):2142. doi: 10.1186/s12889-021-12233-2.
Guglielmetti L, Veziris N, Aubry A, Brossier F, Bernard C, Sougakoff W, et al. Risk factors for extensive drug resistance in multidrug-resistant tuberculosis cases: A case-case study. Int J Tuberc Lung Dis. 2018;22(1):54–9. doi: 10.5588/ijtld.17.0387.
Sriwahyuni E, Lubis R, Aguslina Siregar F. The Effect Of Income, History Of Smoking, Side Effects And Medication Adherence To Drug Resistant Tuberculosis In Haji Adam Malik General Hospital Medan 2018. IJPHCS. 2021;8:2.
Dwi Cahyani T, Ratna Rahayu S, Jazilatun F, Nur Ayu Merzistya A. Multi-Drug Resistant Tuberculosis in Semarang City. Public Heal Perspect J. 2021;6(2):148–58. doi: 10.1183/ 13993003.00626-2020
Wulan Febriyanti R, Sri Lestari E, Hadi P, Rizke Ciptaningtyas V. Tuberkulosis Paru dengan Risiko Multi Drug Resistant di RS Rujukan Tertier di Jawa Tengah. Herb-Medicine Journal. 2021; 4:2
Kumar V, Jorwal P, Soneja M, Sinha S, Nischal N, Sethi P, et al. Evaluation of rapid diagnostic tests and assessment of risk factors in drug-resistant pulmonary tuberculosis. J Family Med Prim Care. 2020;9(2):1028-34. doi: 10.4103/ jfmpc.jfmpc_883_19.
Tao NN, Li YF, Song WM, Liu JY, Zhang QY, Xu TT, et al. 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;11(6):e044349. doi: 10.1136/bmjopen-2020-044349.
Nurdin N. Analisis faktor-faktor determinan Individu terhadap Tuberculosis Multidrug Resistant (TB MDR) di Provinsi Sumatera Selatan. J Kesehat Komunitas. 2020;6(1):63–7.
Soares VM, Almeida IN, Figueredo LJA, Haddad JPA, Oliveira CSF, Carvalho WDS, et al. Factors associated with tuberculosis and multidrug-resistant tuberculosis in patients treated at a tertiary referral hospital in the state of Minas Gerais, Brazil. J Bras Pneumol. 2020;46(2): e20180386. doi: 10.36416/1806-3756/ e20180386.
Hamid M, Brooks MB, Madhani F, Ali H, Naseer MJ, Becerra M, et al. Risk factors for unsuccessful tuberculosis treatment outcomes in children. PLOS ONE. 2019;14(9):e0222776. doi: 10.1371/journal.pone.0222776.
McQuaid CF, Horton KC, Dean AS, Knight GM, White RG. The risk of multidrug- or rifampicin-resistance in males versus females with tuberculosis. Eur Respir J. 2020;56(3). doi: 10.1183/13993003.00626-2020.
Desissa F, Workineh T, Beyene T. Risk factors for the occurrence of multidrug-resistant tuberculosis among patients undergoing multidrug-resistant tuberculosis treatment in East Shoa, Ethiopia. BMC Public Health. 2018; 18(1):422. doi: 10.1186/s12889-018-5371-3.
Ratnasari NY. Faktor Resiko Kejadian Multi Drug Resistant Tuberculosis (MDR TB) di Surakarta, Jawa Tengah. SUARA FORIKES Journal Heal Res. 2020;11(1):67–72.
Gizachew Beza M, Hunegnaw E, Tiruneh M. Prevalence and Associated Factors of Tuberculosis in Prisons Settings of East Gojjam Zone, Northwest Ethiopia. Int J Bacteriol. 2017;2017:3826980. doi: 10.1155/ 2017/3826980.
Yao S, Yan J, Li L, Ma D, Liu J, Wang Q, et al. Determining Mycobacterium tuberculosis Drug Resistance and Risk Factors for Multidrug-Resistant Tuberculosis in Sputum Smear-Positive Tuberculosis Outpatients in Anhui Province, China, 2015-2016. Infect Drug Resist. 2020;13:1023-32. doi: 10.2147/IDR.S244482.
Arroyo LH, Yamamura M, Ramos ACV, Campoy LT, Crispim JA, Berra TZ, et al. Determinants of multidrug-resistant tuberculosis in São Paulo-Brazil: a multilevel Bayesian analysis of factors associated with individual, community and access to health services. Trop Med Int Health. 2020;25(7):839-49. doi: 10.1111/ tmi.13409.
Batte C, Namusobya MS, Kirabo R, Mukisa J, Adakun S, Katamba A. Prevalence and factors associated with non-adherence to multi-drug resistant tuberculosis (MDR-TB) treatment at Mulago National Referral Hospital, Kampala, Uganda. Afr Health Sci. 2021;21(1):238-47. doi: 10.4314/ ahs.v21i1.31.
Bade AB, Mega TA, Negera GZ. Malnutrition is Associated with Delayed Sputum Culture Conversion Among Patients Treated for MDR-TB. Infect Drug Resist. 2021;14:1659-67. doi: 10.2147/IDR.S293461.
Alateah SM, Othman MW, Ahmed M, Al Amro MS, Al Sherbini N, Ajlan HH. A retrospective study of tuberculosis prevalence amongst patients attending a tertiary hospital in Riyadh, Saudi Arabia. J Clin Tuberc Other Mycobact Dis. 2020;21:100185. doi: 10.1016/ j.jctube.2020.100185.
Amala A, Cahyati WH. Drop Out Pengobatan Pada Tuberkulosis Multidrug Resistant (Tb Mdr) Di Kota Semarang: Drop Out of Multidrug Resistant Tuberculosis (Mdr Tb) Treatment in Semarang City. Quality : Jurnal Kesehatan. 2021;15(1):24-36. doi: https://doi.org/10.36082/qjk.v15i1.161
Kamolwat P, Nateniyom S, Chaiprasert A, Disratthakit A, Mahasirimongkol S, Yamada N, et al. Prevalence and associated risk factors of drug-resistant tuberculosis in Thailand: results from the fifth national anti-tuberculosis drug resistance survey. Trop Med Int Health. 2021;26(1):45-53. doi: 10.1111/ tmi.13502.
Fregona G, Cosme LB, Moreira CMM, Bussular JL, Dettoni VDV, Dalcolmo MP, et al. Risk factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. Rev Saude Publica. 2017;51(0):41. doi: 10.1590/S1518-8787.2017051006688.
Tenzin C, Chansatitporn N, Dendup T, Dorji T, Lhazeen K, Tshering D, et al. Factors associated with multidrug-resistant tuberculosis (MDR-TB) in Bhutan: A nationwide case-control study. PLOS ONE. 2020;15(7): e0236250. doi: 10.1371/journal.pone. 0236250.
Kizito E, Musaazi J, Mutesasira K, Twinomugisha F, Namwanje H, Kiyemba T, et al. Risk factors for mortality among patients diagnosed with multi-drug resistant tuberculosis in Uganda- a case-control study. BMC Infect Dis. 2021;21(1):292. doi: 10.1186/s12879-021-05967-2.
Kibret KT, Moges Y, Memiah P, Biadgilign S. Treatment outcomes for multidrug-resistant tuberculosis under DOTS-Plus: a systematic review and meta-analysis of published studies. Infect Dis Poverty. 2017;6(1):7. doi: 10.1186/s40249-016-0214-x.
Aristiana CD, Wartono M. Faktor-faktor yang mempengaruhi terjadinya Multi Drug Resistance Tuberkulosis (MDR-TB). J Biomedika dan Kesehat. 2018;1(1). doi: https://doi.org/ 10.18051/JBiomedKes.2018.v1.65-74
Mbuagbaw L, Guglielmetti L, Hewison C, Bakare N, Bastard M, Caumes E, et al. Outcomes of Bedaquiline Treatment in Patients with Multidrug-Resistant Tuberculosis. Emerg Infect Dis. 2019;25(5):936-43. doi: 10.3201/ eid2505.181823.
Hong H, Dowdy DW, Dooley KE, Francis HW, Budhathoki C, Han HR, et al. Prevalence of Pre-Existing Hearing Loss Among Patients With Drug-Resistant Tuberculosis in South Africa. Am J Audiol. 2020;29(2):199-205. doi: 10.1044/2020_AJA-19-00103.