Clinical Epidemiology of Multidrug Resistant Tuberculosis in a Nodal Drug Resistant- TB Centre in Southern Odisha: A Cross-sectional Study

Nisith Kr Das, Abinash Panda
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Abstract

Introduction: Multidrug-Resistant Tuberculosis (MDR-TB) is a significant public health problem. The number of MDR-TB cases is very high in India and the management is inadequate due to resource constraints. The assessment of MDR-TB burden has to be reliable for programmatic management of MDR-TB under the Revised National Tuberculosis Control Program (RNTCP) of India. Aim: To find the clinico-demographic profile and pattern of MDR-TB among the tuberculosis patients reporting to a nodal tuberculosis centre in Southern Odisha, India. Materials and Methods: The patient record based cross-sectional study was carried out on a convenience sample of 125 sputum positive MDR-TB cases admitted to the Directly Observed Treatment Short-course (DOTS) plus centre of the Nodal Tuberculosis Centre at Berhampur, Odisha, India, during the period from April 2017 to March 2018. A predesigned case record form was used to collect data on the socio-demographic profile, addictions, co-morbidity, Human Immunodeficiency Virus (HIV) status, Bacille Calmette-Guerin (BCG) immunisation status, pattern of drug resistance, history of anti-TB treatment, presenting symptoms at admission, adverse drug reactions observed during the treatment for MDR-TB. The data was analysed using GraphPad Prism trial version 7.0. Descriptive statistics were used to present the final data. Results: Highest number of study participants (95, 76%) were within 18-45 years age group and 90 (72%) of the patients were males. Rural habitation (90, 72%), engagement in labour works (65, 52%), low socio-economic status (75, 60%) were the common socio-economic characteristics. Resistance to rifampicin was the commonest variety 101 (80.8%) and 80 (64%) were newly diagnosed cases of tuberculosis. The commonest presenting symptom was cough in 97 (77.6%) patients and gastrointestinal upset was the commonest adverse drug reaction encountered during therapy. Conclusion: The MDR-TB affects the population in their most productive age. Rifampicin resistant TB was the predominant variety observed in the study population. The MDR-TB can be successfully treated with maximally effective and complete drug regimes.
南奥里萨邦结核结核结核结核结核结核结核结核结核结核结核临床流行病学:横断面研究
耐多药结核病(MDR-TB)是一个重大的公共卫生问题。印度的耐多药结核病病例数量非常高,由于资源限制,管理工作不足。根据印度修订的国家结核病控制规划(RNTCP),耐多药结核病负担评估必须是可靠的,以便对耐多药结核病进行规划管理。目的:了解印度南奥里萨邦结核中心结核患者耐多药结核病的临床人口统计学特征和模式。材料和方法:在2017年4月至2018年3月期间,对印度奥里萨邦Berhampur淋巴结结核中心直接观察短程治疗(DOTS)加中心收治的125例痰阳性耐多药结核病患者进行了基于患者记录的横断面研究。使用预先设计的病例记录表收集有关社会人口统计学概况、成瘾、合并症、人类免疫缺陷病毒(HIV)状况、卡介苗(BCG)免疫状况、耐药模式、抗结核治疗史、入院时出现症状、耐多药结核病治疗期间观察到的药物不良反应等数据。使用GraphPad Prism 7.0试用版分析数据。最终数据采用描述性统计。结果:18-45岁年龄组的患者最多(95例,76%),其中90例(72%)为男性。农村居住(90,72%)、从事劳动(65,52%)、社会经济地位低(75,60%)是共同的社会经济特征。以利福平耐药最为常见,其中101例(80.8%)和80例(64%)为新诊断结核病例。97例(77.6%)患者最常见的临床表现为咳嗽,胃肠道不适是治疗过程中最常见的药物不良反应。结论:耐多药结核病主要发生在最具生产能力的年龄段。利福平耐药结核病是研究人群中观察到的主要品种。通过最有效和最完整的药物制度,可以成功治疗耐多药结核病。
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