Arslan Ahmed Salam, Rizwan Iqbal, Aamir Ikram, Muhammad Asim, Tayyab Razi.
Development of Multidrug-Resistance among Previously Treated Cases of Pulmonary Tuberculosis: a Public Health Concern.
Pak J Med Res Jan ;58(2):46-50.

Background: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a significant global health concern. The most important risk factor for the development of MDR-TB is the previous anti-tuberculosis treatment. Objective: To describe the development of MDR among previously treated cases of Pulmonary Tuberculosis. Study type, settings and duration: A cross-sectional, descriptive study was conducted at PHRC TB Research Center, King Edward Medical University/Mayo hospital, Lahore by involving previously treated patients diagnosed between March 2015 to March 2016. Methodology: All sputum-positive previously successfully treated pulmonary TB cases were subjected to mycobacterium culture, GeneXpert and drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. Results: A total of 139 patients were initially selected but later on only 95 cases of sputum-positive previously treated pulmonary tuberculosis patients were included in the study. Of those, 95 previously treated cases, 40 (42.1%) patients had developed MDR-TB. The mean age of MDR-TB patients was 35.5 +/- 16.7 years; 20 patients (50%) were male and 20 (50%) were female. The prevalence of MDR-TB among previously treated pulmonary tuberculosis patients was found to be 42.1%. Conclusion: The prevalence of MDR-TB in previously treated patients of TB patients was significant. Findings of this report suggest that high ratio of previously treated pulmonary TB patients, developed MDR-TB. Therefore, each patient should be screened for MDR-TB using rapid diagnostic tests (molecular tests) such as the line probe assays, GeneXpert at the end of their treatment. This will facilitate the diagnosis of MDR-TB at an early stage and thus will minimize transmission of the disease.

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