title: Risk factors for multi-drug resistant tuberculosis in patients at tertiary care hospital, Peshawar.
abstract: OBJECTIVE
  To determine the frequency of common risk factors for multi-drug resistant tuberculosis in patients presented at a tertiary care hospital, Peshawar.
  
  
  METHODS
  Cross-sectional, observational study.
  
  
  METHODS
  Pulmonology Department, Khyber Teaching Hospital, Peshawar, from December 2006 to October 2007.
  
  
  METHODS
  Patients with positive AFB culture and sensitivity results and found resistant to both rifampicin and isoniazid with or with resistance to other first line anti-tuberculosis drugs, were recruited from both Pulmonology Ward and Outpatient Department (OPD). Informed verbal consent was taken and a questionnaire administered to all participants of the study. Information regarding demographics, education status, occupation, monthly household income, AFB C/S, details of past history of tuberculosis and family history of TB or Multi-Drug Resistant (MDR-TB) was recorded. Data was analyzed on SPSS version 11.
  
  
  RESULTS
  A total of 30 patients of MDR-TB were interviewed. Male (n=17) and female (n=13) ratio was 1.3:1. Mean age was 34.2+/-15.3 years. Ninety-two percent female and 52.9% male were uneducated. In 56.7%, monthly income was less than 5,000 rupees and in 40% between 5,000-10,000 rupees. All patients had previous history of Antituberculous Treatment (ATT), in which 20% had undertaken ATT course once, 53.3% twice and 26.7% thrice in the past. In the study group, 13 (43.3%) patients had not completed their first ATT course and 11 of them were receiving ATT from a general practitioner (GP) at that time. Seven (23.3%) patients had family history of TB but no one had documented MDR-TB in the family. Resistance to RH was present in all patients; moreover, 56.7% had resistance to RHEZ+S.
  
  
  CONCLUSIONS
  The most common factors in the study group were previous history of tuberculosis, repeated courses of ATT, prescribed by different clinicians and unsupervised treatment by a GP during the initial course of ATT.
authors.affiliation: Department of Pulmonology, Khyber Teaching Hospital, Peshawar. drwahab24@hotmail.com
authors.forename: Fazli
authors.initials: F
authors.lastname: Wahab
authors.forename: Saadia
authors.initials: S
authors.lastname: Ashraf
authors.forename: Naveed
authors.initials: N
authors.lastname: Khan
authors.forename: Rukhsana
authors.initials: R
authors.lastname: Anwar
authors.forename: Mukhtiar Zaman
authors.initials: MZ
authors.lastname: Afridi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010154:Pakistan; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000209:etiology*