title: Risk factors associated with MDR-TB at the onset of therapy among new cases registered with the RNTCP in Mumbai, India.
abstract: BACKGROUND
  Multidrug - resistant TB (MDR - TB) has emerged as a major threat to global TB control efforts in recent years. Facilities for its diagnosis and treatment are limited in many high - burden countries, including India. In hyper - endemic areas like Mumbai, screening for newly diagnosed cases at a higher risk of acquiring MDR - TB is necessary, for initiating appropriate and timely treatment, to prevent its further spread.
  
  
  OBJECTIVE
  To assess risk factors associated with MDR - TB among Category I, new sputum smear-positive cases, at the onset of therapy.
  
  
  METHODS
  The study applied an unmatched case - control design for 514 patients (106 cases with MDR - TB strains and 408 controls with non - MDR - TB strains). The patients were registered with the Revised National Tuberculosis Control Program (RNTCP) in four selected wards of Mumbai during April 2004 - January 2007. Data were collected through semi - structured interviews and drug susceptibility test results.
  
  
  RESULTS
  Multivariate analysis indicated that infection with the Beijing strain (OR = 3.06; 95% C.I. = 1.12 - 8.38; P = 0.029) and female gender (OR = 1.68; 95% C.I. = 1.02 - 2.87; P = 0.042) were significant predictors of MDR-TB at the onset of therapy.
  
  
  CONCLUSIONS
  The study provides a starting point to further examine the usefulness of these risk factors as screening tools in identifying individuals with MDR-TB, in settings where diagnostic and treatment facilities for MDR-TB are limited.
authors: Foundation for Research in Community Health, Pune, India. atresachin2000@yahoo.com
authors: Sachin R
authors: SR
authors: Atre
authors: Desiree T B
authors: DT
authors: D'Souza
authors: Tina S
authors: TS
authors: Vira
authors: Anirvan
authors: A
authors: Chatterjee
authors: Nerges F
authors: NF
authors: Mistry
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult