Saeed Khan, Mazhar Ali Khan, Syed Muhammad Nasir, Akmal Naveed, Abdul Latif, Arshad Javaid.
Factors associated with new and re-treated Multidrug-Resistant Tuberculosis in Khyber Pakhtunkhwa.
Pak J Chest Med Jan ;25(2):74-82.

Background: The resurgence of Tuberculosis (TB) in the form of Multi-drug Resistant Tuberculosis (MDR-TB) is a major threat to all efforts of TB control programme throughout the world. Previous treatment with antituberculosis (ATT) and its related risk factors associated with MDR-TB is of great importance. Therefore, this study was conducted with the aim to find out the factors associated with development in new and previously treated MDR-TB. Methodology: A retrospective record review study was conducted at Programmatic Management of Drug Resistant TB (PMDT) Unit, Lady Reading Hospital (LRH) Peshawar, Pakistan on all enrolled MDR-TB patients from January 2012 till December 2015. Data collection included social demographic characteristics, past medical history and behavioral risk factors. Data was analyzed using multiple logistic regressions after transferring into SPSS version 20. Results: In this study a total of 1168 MDR-TB patients included from the year 2012 to 2015. Among the study cases majority of the patients (56.2%) were female and 49.8% were from group age 21 to 40 years of age. Twenty three percent of the study cases were age less than 40 Kg at their baseline of treatment. Most of the patients 66.8% were from rural area and 78.3% were unmarried. Among study cases number of patients declared as re-treated were of higher number (1013) as compared to new cases (155). In both groups numbers of female patients (7.3% & 49.0%) were high as compared to male. Significant associations were found between re-treated and new MDR-TB cases factors such as marital status (P < 0.002), family history of TB (P< 0.001), duration of illness (p < 0.002) and smoking or other drugs etc addicts (P < 0.004). By multiple logistic regression, the significant potential factors include Family history with TB, past treatment, drugs etc addiction, aged people showed positive significant association within retreatment studied MDR-TB cases by AOR[(95%CI) 5.26(2.76 - 86), (P < 0.004)] drug abuse/smoking etc [11.35 (1.17 - 34.61), (P < 0.002), aged people [(9.3 (2.76 - 11.78), (P < 0.001)]. Conclusion: This study concluded that gender, previously treated patients, patients with longer time of duration, smoking or drug abuse and marital status were factors significantly associated with previously treated MDR-TB cases and previously treated with new patients also treated with antitubercolous treatment. These findings would be beneficial to our TB control programme and help in the control of TB/MDR-TB and cut off the chain of disease and lower the prevalence and incidence of TB/MDR-TB.

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