Descriptive epidemiology of multidrug-resistance tuberculosis, Makarak Hospital, 2007-2015

Abstract

Multidrug-resistant tuberculosis (MDR-TB) cases, reported by Makarak Hospital continuously occur since 2007. The authors reviewed all MDR-TB cases found or registered in the hospital during 2007 to June 2015. Data were collected from registration, record and database system of the hospital betweenFebruary and September 2015. We analyzed their descriptive epidemiology and other related factors in orderto get better understanding on the issue and recommending further improved response. It was found that dataof 240 studied cases was partially completed for reviewing. MDR-TB cases increased from 9.7% in fiscalyear 2007 to 17.2% in 2011 and decline to 8.8% in 2015. Ratio between new and acquired MDR-TB was1.67:1. The majority of cases (50.8%) were male, whereas 47.1% were female. The rest of cases couldnot be gender identified. Two cases were non-Thai (0.8%). Cases were identified in all age-groups and the majority of cases (45.5%) were the ages of 21-45 years. The majority of cases (82.4%) resided in Tamaka District with scattering in all sub-districts, whereas the rest of cases resided in other districts of Kanchanaburi Province and other provinces. Drug-susceptibility-tests (DST) results indicated resisting several drugs.Treatment outcome data was available in 177 cases while no such data in other 63 cases. Of the patients whose treatment outcomes were available, 77 cases (43.5%) were cured, 39 cases (22%) were completed, 7 cases (7.9%) were defaulted, 2 cases (1.1%) were transferred-out, 5 cases (2.8%) were failure treatment, 1 case (0.6%) was unclassified (other) patients for registration, and 39 cases (22%) died. The treatment results of 1 pre-extensively drug-resistant tuberculosis (pre-XDR-TB) case and 12 extensively drug-resistant tuberculosis (XDR-TB) revealed 1 case (7.7%) was ongoing treatment, 3 cases (23.1%) of defaulted treatment and 3 cases (23.1%) of failure treatment, and 6 dead cases (46.1%). The study revealed sufficient information for getting better understanding of the disease epidemiology and scope of MDR-TB serious problems. According to our study findings, we can hypothesize that MDR-TB may continuously occur and spread to other areas of Thailand. We recommend rigorously continuing the monitoring of MDR-TB situation, including the research and development on MDR-TB prevention, control, diagnosis, treatment and MDR-TB data-information system for supporting MDR-TB control program implementation in Kanchanaburi Province and other potentially epidemic areas of Thailand.