Keywords : multidrug resistance
Iraqi Postgraduate Medical Journal,
2015, Volume 14, Issue 1, Pages 65-70
Multidrug-resistant tuberculosis (MDR-TB) is caused by strains of Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin, the two most effective bactericidal agents currently available for TB treatment.It has emerged as a global public health emergency . It requires treatment with combination therapy consisting of four to six medications for up to 2 years . Additionally, the treatment is generally more toxic and far more expensive than the standardized treatment regimen used to treat drug-susceptible TB . The latest estimates of the World Health Organization (WHO) arrive at 650 000 prevalent MDR-TB cases among the 12 million tuberculosis cases worldwide.
To identify the Characteristics of multidrug resistance tuberculosis cases attending the specialized center for chest and respiratory disease in Baghdad during the period 9th of September 2012 – 9th of December 2012.
A cross sectional study was done in the specialized center for chest and respiratory disease in Baghdad during the period 9th of September 2012 – 9th of December 2012.Any patient attending the specialized center for chest and respiratory disease in Baghdad during the study period diagnosed as a case of MDR TB was enrolled in this study.
The sample is composed of 42 MDR-TB patients (29 male and 13 female ) , with age mean of 38.3±12.8 year . Male sex significantly dominates and exceeds two thirds of the sample (69.0%) (P < 0.05). The study find ages between 25-45 year contribute to about two thirds (62.0%) of patients, and ages between 55-65 years constitute about one fifth (19.0%) of the sample. (P < 0.05). Body habit significantly showed that half the sample (50.0%) were underweight and only 10% were overweight or obese (P < 0.05).Smoking is found in 21.4% of total sample.
The duration of taking first line antituberculosis drugs (FLD) before being labeled as MDR-TB varied from 14 to 72 months, with mean duration of 27.3±15.2 months with no significant difference in mean duration between the two sexes (P > 0.05,). Time required to diagnose these cases as MDR-TB varied from 0 to 24 months with mean time of 9.0±6.5 months. There was no significant difference in mean diagnosis time between males and females (P > 0.05). This study found that around one fifth (19.0%) of the sample have a history of default from treatment with FLD. Only one female was significant to be a case of primary MDR-TB (P > 0.05). Two cases (both were males) significantly had history of reaction to FLD treatment (P < 0.05). None of the sample had positive HIV testing.
Most MDR patients in this study were males aged between 25-45 years .Most cases had acquired MDR TB and primary MDR-TB was rare finding in this study. Around one fifth of the sample have a history of default from treatment with FLD.