DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20182039

Prevalence of rifampicin resistant mycobacterium tuberculosis and associated factors among presumptive tuberculosis patients in eastern Uttar Pradesh: a cross sectional study

Praveen B. Gautam, Ashwini Mishra, Santosh Kumar

Abstract


Background: Drug resistant tuberculosis threatens global TB control and is a major public health problem in several countries and India has the highest tuberculosis in the world. The rifampicin resistance is a good predictor of multidrug resistant tuberculosis. The aim of this study was to determine the prevalence of rifampicin resistance M. tuberculosis and associated factor among presumptive tuberculosis patients in eastern Uttar Pradesh.

Methods: A cross-sectional study was conducted from October 2016 to September 2017. Detection of M. tuberculosis and resistance to rifampicin was performed using Gene Xpert MTB/RIF assay. Data was collected using pre-structured questionnaire by face to face interview. The chi-square test was used to assess the statistical significance of each ratio, p<0.05 was considered significant.

Results: Out of 510 patients, Mycobacterium tuberculosis was detected in 168 (32.9%). Out of these 168 patients, the prevalence of rifampicin resistance tuberculosis was 44 (26.1%). It was higher among male 38 (30.6%) than female 6 (13.6%). Regarding age distribution, maximum numbers of rifampicin resistance patients were in the age group of 20-40 years 36.7%. The prevalence of rifampicin resistance was 36 (27.6%) and 8 (21.0%) in pulmonary and extra-pulmonary respectively. Out of 44 rifampicin resistant cases, 39 (37.8%) were previously treated and 5 (7.6%) cases were treatment naïve patients. In this study, among presumptive DRTB cases, new 2 (11.7%), relapse 13 (39.3%), failure 23 (46.0%), loss to follow-up 1 (10.0%) and MDR contact 1 (20.0%) respectively were rifampicin resistant and one HIV seropositive patient was found to be rifampicin resistant.

Conclusions: Previously treated cases were significantly associated with rifampicin resistance tuberculosis. The Gene Xpert is a good equipment for rapid detection and management of drug resistant tuberculosis for both pulmonary as well as extra-pulmonary tuberculosis.


Keywords


MDR-TB, Gene Xpert MTB/RIF, Rifampicin resistance

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References


Central TB Division, Directorate General of Health Services, Ministry of health and family welfare nirman bhawan, New Delhi. Available at: http://www.tbcindia.gov.in. Revised National TB Control Programme, annual status report 2017.

Tuberculosis WHO Global Tuberculosis Report 2015. Available at: http/www.whoint/tb/ publication/factsheet_globalpdf. Accessed on 3 February 2018.

Guidelines on programmatic management of drug resistant tuberculosis in India, RNTCP 2017.

Ormerod LP. Multi-drug resistant tuberculosis (MDR-TB) epidemiology, prevention and treatment. British Medical Bulletin 2005;73and74:17-24.

Chang K, Lu W, Wang J. Rapid and effective diagnosis of tuberculosis and rifampicin resistance with Xpert MTB/RIF assay: a meta analysis. J Infect. 2012;64(6):580-8.

Tessema B, Beer J, Emmrich F, Sack U, Rodloff AC. First- and second-line anti-tuberculosis drug resistance in Northwest Ethiopia. Int J Tuberc Lung Dis. 2012;16(6):805–11.

Getahun M, Ameni G, Kebede A, Yaregal Z, Hailu E, Medihn G, et al. Molecular typing and drug sensitivity testing of Mycobacterium tuberculosis isolated by a community-based survey in Ethiopia. BMC Public Health. 2015;15:751.

Story BE, Helb D. Evaluation of the analytical performance of the Xpert MTB/RIF assay. J Clin Microbiol. 2010;48(7):2495–501.

Technical and operational guidelines for tuberculosis control in India, RNTCP 2016.

Alvarez-Uria G, Azcona JM, Midde M, Naik PK, Reddy S, Reddy R. Rapid diagnosis of pulmonary and extra-pulmonary tuberculosis in HIV-infected patients. Comparison of LED Fluorescent Microscopy and the GeneXpert MTB/RIF assay in a district hospital in India. Tuberc Res Trea. 2012;2012:1–4.

Dinic L, Akande P, Idigbe EO, Ani A, Onwujekwe D, Agbaji O, Akanbi M, Nwosu R. Genetic determinants of drug-resistant tuberculosis among HIV infected patients in Nigeria. J Clin Microbiol. 2012;50(9):2905–9.

Paramasivan CN, Venkataraman P, Chandrasekaran V, Bhat S, Narayanan PR. Surveillance of drug resistance intuberculosis in two districts of South India. Int J Tuberc Lung Dis. 2002;6(6):479-84.

Malhotra B, Pathak S, Vyas L, Katoch VM, Srivastava K, Chauhan DS, et al. Drug susceptibility profiles of mycobacterium tuberculosis isolates at Jaipur. Indian J Med Microbiol. 2002;20(2):76-8.

Jain NK, Chopra KK, Prasad G. Initial and acquired INH and rifampicin resistant to Mycobacterium tuberculosis and its implication for treatment. Indian J Tuberc. 1992;39:180-6.

Chowgule RV, Deodhar L. Pattern of secondary acquired drug reistance to antituberculosis drug in Mumbai, India -1991-1995. Indian J Chest Dis Allied Sci. 1998;40:23-31.

Faustini A, Hall AJ, Perucci CA. Risk factors for multidrug resistant tuberculosis in Europe: a systematic review Thorax. 2006;61:158–63.

Rasaki SO, Ajibola A, Musa SA, Moradeyo AK, Odeigah LO, Abdullateef SG, et al. Rifampicin Resistant Tuberculosis in a Secondary Health Institution in Nigeria, West Africa. J Infect Dis Ther. 2014;2(3):1000139.

Sharma SK, Kumar S, Saha PK, George N, Arora SK, Gupta D, et al. Prevalence of multidrug-resistant tuberculosis among Category II pulmonary tuberculosis patients. Indian J Med Res. 2011;133:312-5.

Santha T, Gopi PG, Rajeswari R, Selvakumar N, Subramani R, Chandrasekaran V, Rani B, et al. Is it worth treating Category I failure patients with Category II regimen? Indian J Tuberc. 2005;52:203–6.

Singla R, Srinath D, Gupta S. Risk factors for new pulmonary tuberculosis patients failing treatment under the Revised National Tuberculosis Control Program, India. Int J Tuberc Lung Dis. 13(4):521–6.

Gupta Anil M, Nilesh D, Patel N. Prevalence of Multi Drug Resistance-TB in Category-2 failure. Gujarat Med J. 2014;69:44-7.

Joydeep G, Souvik R, Suman N. A study to evaluate pattern of rifampicin resistance in case of sputum positive pulmonary tuberculosis. J Evol Med Dental Sci. 2015;28(6):4762-8.

Gaude GS, Kumar P, Hattiholli J. Drug resistance patterns among pulmonary tuberculosis patients in tertiary care hospital in northern Karnataka. J Med Trop. 2015;17:81-6.

Chakraborty S, Chakraborty A, Talukder T, Mukherjee M, Chatterjee T. Prevalence of Mycobacterium tuberculosis Strains Isolated from Both Pulmonary and Extra Pulmonary Samples and Their Resistance to Rifampicin: A Study from Kolkata and Surrounding Suburbs. J Tuberculosis Res. 2016;4:61-71.