Multidrug resistant tuberculosis: prevalence and risk factors in districts of Metema and West Armachiho, Northwest Ethiopia

Multidrug resistant tuberculosis: prevalence and risk factors in districts of Metema and West Armachiho, Northwest Ethiopia

By: Feleke Mekonnen, Belay Tessema, Feleke Moges, Aschalew Gelaw, Setegn Eshetie, Gemechu Kumera
Publication: BMC Infectious DiseasesOct. 2015;15: 461. DOI: 10.1186/s12879-015-1202-7.

Abstract

Background

Multi drug resistant tuberculosis (MDR-TB) is an emerging challenge for TB control programs globally. According to the World Health Organization, 2012 report, Ethiopia stands 15th out of the 27 high priority countries in the world and 3rd in Africa. Updated knowledge of the magnitude of MDR-TB is so substantial to allocate resources, and to address prevention and control measures. Therefore, the aim of this study was to assess the prevalence of MDR-TB and associated risk factors in West Armachiho and Metema districts of North Gondar.

Methods

A cross-sectional study was conducted in West Armachiho and Metema districts between February 01 and June 25, 2014. A total of 124 consecutive smear positive pulmonary tuberculosis patients were included in the study. Socio-demographic and possiblerisk factor data were collected using a semi-structured questionnaire. Drug susceptibility testing was first performed for rifampicin using GeneXpert MTB/RIF. For those rifampicin resistant strains, drug susceptibility testing was performed for both isoniazid and rifampicin to identify MDR-TB.

Results

Of 124 smear-positive pulmonary TB patients, 117 (94.4 %) were susceptible to rifampicin, while 7 (5.7 %) were confirmed to be resistant to rifampicin and isoniazid. The overall prevalence of MDR-TB was 5.7 % (2.3 % among new cases and 13.9 % among previously treated cases). History of previous treatment (OR = 7, P = 0.025) was a significantly associated risk factor for MDR-TB.

Conclusion

Maximizing early case detection and treatment, strengthening TB infection control activities and proper implementation of DOTS are recommended to reduce the burden of MDR-TB.