Multidrug resistant tuberculosis: prevalence and risk factors in districts of metema and west armachiho, Northwest Ethiopia.
BACKGROUND
Multi drug resistant tuberculosis (MDR-TB) is an emerging challenge for TB control programs globally. According to World health organization, 2012 report Ethiopia stands 15(th) out of the 27 high priority countries in the world and 3(rd) in Africa. Updated knowledge of the magnitude of MDR-TB is so substantial to allocate resources, and to address prevention and control measures. Therefore, the aim of this study was to assess the prevalence of MDR-TB and associated risk factors in West Armachiho and Metema districts of North Gondar.


METHODS
A cross-sectional study was conducted in West Armachiho and Metema districts between February 01 and June 25, 2014. A total of 124 consecutive smear positive pulmonary tuberculosis patients were included in the study. Socio-demographic and possible risk factor data were collected using a semi-structured questionnaire. Drug susceptibility testing was first performed for rifampicin using GeneXpert MTB/RIF. For those rifampicin resistant strains, drug susceptibility testing was performed for both isoniazid and rifampicin to identify MDR-TB using the proportional method on LJ media. Data were analyzed using statistical Package SPSS version 20; binary logistic regression was used to assess the association. P-values < 0.05 were considered as statistically significant.


RESULTS
Of 124 smear-positive pulmonary TB patients, 117 (94.4 %) were susceptible to Rifampicin, while 7 (5.7 %) were confirmed to be resistant to Rifampicin and Isoniazid. The overall prevalence of MDR-TB was 5.7 % (2.3 % among new cases and 13.9 % among previously treated cases). History of previous treatment (OR = 7, P = 0.025) was significantly associated risk factor for MDR-TB.


CONCLUSIONS
The overall prevalence of MDR-TB was 5.7 % among cases at five health centers and a history of previous treatment was found to be a risk factor for being infected by an MDR-TB strain. Therefore, maximizing early case detection and treatment, strengthening TB infection control activities and proper implementation of DOTS are recommended to reduce the burden of MDR-TB.
Management Science for Health (MSH), HEAL-TB, Gondar, Ethiopia. atnatiosg@yahoo.com.
Feleke
F
Mekonnen
Department of Microbiology, School of Biomedical and Laboratory sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, P O. box: 196, Ethiopia. bt1488@yahoo.com.
Belay
B
Tessema
Department of Microbiology, School of Biomedical and Laboratory sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, P O. box: 196, Ethiopia. Mogesfeleke@gmail.com.
Feleke
F
Moges
Department of Microbiology, School of Biomedical and Laboratory sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, P O. box: 196, Ethiopia. aschalew3@gmail.com.
Aschalew
A
Gelaw
Department of Microbiology, School of Biomedical and Laboratory sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, P O. box: 196, Ethiopia. wolet03.2004@gmail.com.
Setegn
S
Eshetie
Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia. gemechukumera@ymail.com.
Gemechu
G
Kumera
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000472:pathogenicity; D012293:Rifampin / Q000494:pharmacology / Q000627:therapeutic use; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin