Prevalence and Analysis of Drug Resistance Pattern of MDR-TB in Retreatment Cases at Allied Hospital, Faisalabad, Pakistan

Sana Arif; Qamar Mehboob; Waqar Arif

doi:10.29054/apmc/2020.994

Sana Arif House Officer, Allied Hospital, Faisalabad Medical University, Faisalabad, Pakistan
Qamar Mehboob Associate Professor, Department of Physiology, Faisalabad Medical University, Faisalabad
Waqar Arif Post Graduate Resident Plastic Surgery department, Allied Burn & Reconstructive Surgery Center Faisalabad Medical University, Faisalabad, Pakistan

DOI: https://doi.org/10.29054/apmc/2020.994

Keywords: Multi drug resistance, Retreatment cases,, Tuberculosis

Abstract

Background: The prevalence of Multi-Drug Resistance-Tuberculosis (MDR-TB) among retreatment cases is very high. It has become a serious public health issue in Pakistan and can affect greatly TB control strategies. So, we conducted the present research work to update a systematic review of the literature available on MDR-TB cases. Objective: To analyze the resistance pattern of multidrug-resistant tuberculosis. To study the prevalence of MDR-TB among new cases, retreatment cases. Study Design: Cross-sectional study. Settings: Pathology department, Allied Hospital, Faisalabad Medical University, Faisalabad, Pakistan. Duration: Six months from January 01, 2020 to June 30, 2020. Methodology: In this study, we included new and retreatment tuberculosis cases. Gene mutation RpoB, DNA band sequence detected by using machine, Cepheid gene Xpert IV – 4 Modules, Sr # 806133. Data was collected and analyzed statistically by using SPSS v 20. Results: 858 cases were included of age 12 years – 100yrs with the mean age (in years) 42.139 ± 16.823. Two groups of males and females were studied separately. Group I included male patients {456 (56.64%)} and further subdivided into IA [age above 30 years, {354(72.84%)}] and IB [age below 30 years {132 (27.15%)}]. Group II included female patients {372 (43.36%)} and further subdivided into IIA [age above 30 years {239 (64.25%)}] and IIB [age below 30 years {133(35.75%)}]. Out of 858 cases, 347 (40.44%) were New cases, 13 (1.51%) New cases with HIV and 408 (47.55%) were Previously Treated patients (PT). 30 (3.45%) cases were unknown (UK). 28 (3.26%) cases were brought by different lady health workers (LHW) and relapse cases were 32 (3.73%). Overall statistical analysis was found to be highly significant (p=0.000, df= 1, CI= 95%). According to our results, in 517 (60.26%) patients, Mycobacterium Tuberculosis was not detected (MTB-ND). In 214 (24.94%) cases, Mycobacterium Tuberculosis was detected (MTB-D), out of which 13 (6.07%) cases were of First-Line Multi Drug Resistance (MDR). Age of MDR cases was in between 17- 70 years with the mean age (in years) 37.307 ± 17.637. Our results showed MDR more in males (53. 85%) as compared to female patients (46. 15%). Our results showed a significant correlation between status of all cases and their reports (p= -.050). For MTB-ND cases p= 0.000, df =1, CI=95% and for invalid cases p= 0.000, df =5, CI=95%. Conclusion: There is a great need to implement national tuberculosis guidelines fully. In order to prevent further emergence of drug resistance, we should focus on effective implementation of directly observed therapy short courses.