title: Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study.
abstract: BACKGROUND
  Multidrug-resistant tuberculosis (MDR-TB) has emerged as a major clinical public health threat and challenges the national TB control program in Malaysia. Data that elaborates on the risk factors associated with the development of MDR-TB is highly limited in this country. This study was aimed to determine the risk factors associated with the development of MDR-TB patients in peninsular Malaysia.
  
  
  METHODS
  This was a case control study; the data were collected from medical records of all the registered MDR-TB patients at five referral TB hospitals in peninsular Malaysia from January 2010 to April 2014. The 105 cases were all confirmed by a positive sputum culture of Mycobacterium tuberculosis for MDR-TB and extensively drug-resistant (XDR)-TB. As a comparison, a total of 209 non-MDR-TB cases were randomly selected as controls.
  
  
  RESULTS
  A total of 105 MDR-TB and 209 non MDR-TB patients were studied. The risk factors associated with MDR-TB within the multivariate analysis were previous tuberculosis treatment, HIV infection, being an immigrant, and high load of positive for acid-fast bacillus (AFB) smear.
  
  
  CONCLUSIONS
  The findings of this study revealed that patients who had received previous treatment for tuberculosis, were infected with HIV, were immigrants, and had a high burden of positive testing for AFB smear were more likely to have MDR-TB. An enhanced understanding of the risk factors associated with MDR-TB strains is imperative in the development of a national policy for public health interventions.
authors.affiliation: School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia. nadara2@yahoo.com.
authors.forename: Omar Sald
authors.initials: OS
authors.lastname: Elmi
authors.forename: Habsah
authors.initials: H
authors.lastname: Hasan
authors.forename: Sarimah
authors.initials: S
authors.lastname: Abdullah
authors.forename: Mat Zuki
authors.initials: MZ
authors.lastname: Mat Jeab
authors.forename: Zilfalil
authors.initials: Z
authors.lastname: Bin Alwi
authors.forename: Nyi Nyi
authors.initials: NN
authors.lastname: Naing
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D012189:Retrospective Studies; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*; D055815:Young Adult