DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20212353

Prevalence of multi-drug resistant tuberculosis and factors associated with treatment outcome in three districts of Himachal Pradesh, India

Pushpinder Verma, Balbir Singh, Pramod K. Shridhar, Gurmeet Singh, Sukhjinder Pal Singh, Parth Rajdev

Abstract


Background: Tuberculosis (TB) is a leading cause of morbidity and mortality in the world and especially in India. MDR TB has emerged as a major challenge in TB control in India. The prevalence of MDR TB is on the rise in India. We did this study to see the prevalence of MDR TB in 3 districts of Himachal Pradesh and to study the factors affecting treatment outcomes.

Methods: The period of the study was from January 2019 to December 2019. We collected data of MDR TB patients from district TB offices of Solan, Bilaspur and Hamirpur. Information from patients was collected through questionnaires while interviews were conducted with district project officer and other health officials and documents, brochures, etc. were collected from Solan, Hamirpur and Bilaspur.

Results: Overall prevalence rate of MDR TB in our study was 3.14%. Among new TB cases, the prevalence rate of MDR TB was 2.42% (81/3345), and among old treated cases was 9% (37/411). 31% MDR TB patients were old treated while 69% patients had no previous treatment history. The default rate was low in our study (0.84%) while 8 (6.4%) patients had treatment interruption but for less than 15 days.

Conclusions: The prevalence in our study is comparable to the national drug resistance survey. Early detection, timely treatment and contact tracing is vital in decreasing the MDR TB cases. Better supervision, constant monitoring, proper counselling and timely identification and management of adverse effects of the drugs will improve the treatment outcome among MDR TB patients.


Keywords


Multidrug resistant TB, Himachal Pradesh, Prevalence

Full Text:

PDF

References


World Health Organization. Global Tuberculosis report; 2018. Available at: https://apps.who.int/iris/handle/10665/274453. Accessed on 1 Jan 2021.

World Health Organization. Global Tuberculosis Programme. TB: A global emergency, WHO report on the TB epidemic. 1994. Available at: https://apps.who.int/iris/handle/10665/58749. Accessed on 1 Jan 2021.

Central TB Division. TB India 2018. India: Directorate General of Health Services MoHFW. 2018. Available at: https://tbcindia.gov.in/showfile.php?lid=3314. Accessed on 1 Jan 2021.

Central TB Division. First National Tuberculosis Drug Resistance survey in India. India: Directorate General of Health Services MoHFW. 2018. Available at: https://tbcindia.gov.in/showfile.php?lid=3315. Accessed on 1 Jan 2021.

Mehari K, Asmelash T, Hailekiros H, Wubayehu T, Godefay H, Araya T et al. Prevalence and Factors Associated with Multidrug-Resistant Tuberculosis (MDR-TB) among Presumptive MDR-TB Patients in Tigray Region, Northern Ethiopia. Can J Infect Dis Med Microbiol. 2019:2923549.

Sinha P, Srivastava GN, Gupta A, Anupurba S. Association of risk factors and drug resistance pattern in tuberculosis patients in North India. J Global Infect Dis. 2017;9(4):139-45.

Sharma SK, Kaushik G, Jha B, George N, Arora SK, Gupta D et al. Prevalence of multidrug-resistant tuberculosis among newly diagnosed cases of sputum-positive pulmonary tuberculosis. Indian J Med Res. 2011;133(3):308-11.

Lohiya A, Suliankatchi AR, Rath RS, Jacob O, Chinnakali P, Goel AD. Prevalence and patterns of drug resistant pulmonary tuberculosis in India-A systematic review and meta-analysis. J Global Antimicrobial Resistance. 2020;22:308-16.

Rifat M, Milton AH, Hall J, Oldmeadow C, Islam MA, Husain A. Development of Multidrug Resistant Tuberculosis in Bangladesh: A Case-Control Study on Risk Factors. PLoS One. 2014;9(8);e105214.

Stosic M, Vukovic D, Babic D, Antonijevic G, Foley KL, Vujcic I et al. Risk factors for multidrug-resistant tuberculosis among tuberculosis patients in Serbia: a case-control study. BMC Public Health. 2018;18(1):1114.

Royce S, Falzon D, van Weezenbeek C, Dara M, Hyder K, Hopewell P et al. Multidrug resistance in new tuberculosis patients: burden and implications. Int J Tuberc Lung Dis. 2013;17(4):511-3.

Ershova JV, Volchenkov GV, Kaminski DA. Epidemiology of Primary Multidrug-Resistant Tuberculosis, Vladimir Region, Russia. Emerg Infect Dis. 2015;21(11):2048-51.