Factors influencing the risk of developing multidrug-resistant pulmonary tuberculosis in Northeast Thailand

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2025-07-02 DOI:10.1016/j.jctube.2025.100549

Nion Leeka , Wongsa Laohasiriwong , Roshan Kumar Mahato , Kittiporn Amprarat , Seksan Chaisuksant

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Abstract

Background

This study aimed to identify the factors influencing Multidrug-Resistant Pulmonary Tuberculosis (MDR-TB) in Northeast Thailand.

Methods

A case-control study was conducted by reviewing medical record and collecting primary data using a structured questionnaire. The study population comprised the case group of patients with MDR-TB and the control group consisted of other pulmonary tuberculosis patients aged 18 years and over with ratio 1 case: 3 controls. The factors influencing MDR-TB in the Northeast of Thailand were identified by multivariable analysis.

Results

The results revealed that the majority of the cases and controls were males (73.79 % and 59.87 %, respectively) with mean ages of 50.50 years and 56.30 years. Cases had more moderate self-care behaviors (40.78 %) compared with controls (17.15 %). Nearly half (48.54 %) of the cases had a limited level of health literacy. Multivariable analysis demonstrated that education level (Adjusted Odd Ratio (AOR) = 1.12; 95 % CI = 1.14–1.96, p = 0.04), average monthly family income (AOR = 1.78; 95 % CI = 1.19–2.97, p = 0.01), number of windows (AOR = 2.03; 95 % CI = 1.34–3.91, p = 0.001), being diagnosed with tuberculosis two or more times (AOR = 4.63; 95 % CI = 2.51–12.35, p < 0.001), poor attitude towards tuberculosis illness (AOR = 1.32; 95 % CI = 1.05–2.48, p = 0.03), mild to moderate self-care behavior levels (AOR = 1.47; 95 % CI = 1.14–3.05, p < 0.001), and inadequate to problematic levels of health literacy (AOR = 2.11; 95 % CI = 1.36–3.63, p < 0.001) were significant determinants of MDR-TB.

Conclusions

This study concluded that education level, monthly family income, number of windows, recurrence of TB diagnosis, attitude towards TB illness, self-care behavior level and limited health literacy level were risk factors of MDR-TB. Inadequate health literacy was particularly associated with a high risk of developing MDR-TB. In order to increase treatment success rates, the results from this study should be used to improve targeted interventions and health education strategies.

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影响泰国东北部发生耐多药肺结核风险的因素

本研究旨在确定泰国东北部地区耐多药肺结核（MDR-TB）的影响因素。方法采用病例对照研究方法，查阅病案资料，采用结构化问卷收集原始资料。研究人群包括耐多药结核病患者病例组和其他18岁及以上肺结核患者的对照组，1例：3例对照。通过多变量分析确定泰国东北部耐多药结核病的影响因素。结果本组病例以男性居多，分别为73.79%和59.87%，平均年龄为50.50岁和56.30岁。患者有较多的中度自我护理行为（40.78%），对照组为17.15%。近一半（48.54%）的病例卫生知识水平有限。多变量分析表明，受教育程度(调整奇数比(AOR) = 1.12；95% CI = 1.14-1.96, p = 0.04)，家庭月平均收入(AOR = 1.78；95%可信区间-2.97 = 1.19,p = 0.01), windows(优势比= 2.03;95% CI = 1.34-3.91, p = 0.001)，两次或两次以上被诊断为结核病(AOR = 4.63；95% CI = 2.51-12.35, p <；0.001)，对结核病的态度差(AOR = 1.32；95% CI = 1.05-2.48, p = 0.03)，轻至中度自我照顾行为水平(AOR = 1.47；95% CI = 1.14-3.05, p <；0.001)，健康素养水平不足(AOR = 2.11；95% CI = 1.36-3.63, p <；0.001)是耐多药结核病的重要决定因素。结论受教育程度、家庭月收入、窗口数、结核病诊断复发率、结核病态度、自我保健行为水平和有限健康素养水平是耐多药结核病的危险因素。卫生知识普及不足与发生耐多药结核病的高风险特别相关。为了提高治疗成功率，本研究的结果应用于改进有针对性的干预措施和健康教育策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.