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ชเลวัน ภิญโญโชติวงศ์
Internal Medicine, Charoenkrung Pracharak Hospital, Medical Service Department, Bangkok
Abstract
Introduction: Multidrug-resistant (MDR) tuberculosis has been a cause of concern for tuberculosis control in Thailand. Previous treatment has been documented as a strong risk factor for MDR tuberculosis. However, other risk factors for MDR-TB are unclear.
Objective: This study aimed to analyse prevalence of MDR tuberculosis and risk factors associated to MDR tuberculosis.
Material and Methods: This was a retrospective study. A total of 1,173 culture-confirmed, pulmonary tuberculosis patients registered from 1 January 2008 to 31 December 2014 at Charoenkrung Pracharak Hospital. The database of medical records such as baseline characteristics, comorbidities and history of previous anti-tuberculosis treatment were analysed by Parametric t-test and non parametric Chi-square test or Fisher exact test.
Results: Among 1,173 patients, 802 patients (68.37%) were male and 371 patients (31.62%) were female. The average age was 42.9 ± 16.2 years. Prevalence of primary and secondary MDR tuberculosis is 3.13% and 12.62%, respectively. Patients with previous anti-tuberculosis treatment had a strong risk of MDR tuberculosis (odds ratio [OR] 22.8; 95% confidence interval [CI] 4.1-125.8; p<0.001) when compared with those previously not having been treated. And female patients was independent risk factor for the patient with MDR tuberculosis (odds ratio [OR] 10; 95% confidence interval [CI] 0.01-0.7; p<0.05) compared with male patients.
Conclusion: The high prevalence of MDR tuberculosis has been a major health problem in Thailand and Bangkok city. Patients with previous anti-tuberculosis treatment and female patients were independent risk factors of MDR tuberculosis. The results of this analysis of drug resistance of tuberculosis can develop and implement to direct infection control measures and to optimize treatment.
Keywords: prevalence, risk factors, multidrug-resistant tuberculosis
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