Search

Objective: To assess the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients., Methods: Close contacts of MDR-TB patients were traced in the cross-sectional study. Different clinical, radiological and bacteriological were performed to rule out the evidence of TB/MDR-TB., Results: Between January 2012 and December 2012, a total of 200 index MDR-TB patients were initiated on MDR-TB treatment, out of which home visit and contacts screening were conducted for 154 index cases. Of 610 contacts who could be studied, 41 (17.4%) were diagnosed with MDR-TB and 10 (4.2%) had TB. The most common symptoms observed were cough, chest pain and fever., Conclusions: The high incidence of MDR-TB among close contacts emphasize the need for effective contact screening programme of index MDR-TB cases in order to cut the chain of transmission of this disease., (Copyright © 2016 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.)

Background: Fluoroquinolones are the backbone of multidrug resistant tuberculosis treatment regimens. Despite the high burden of multidrug resistant tuberculosis in the country, little is known about drug resistance patterns, prevalence, and predictors of fluoroquinolones resistance among multidrug resistant tuberculosis patients from Pakistan., Objective: To evaluate drug resistance patterns, prevalence, and predictors of fluoroquinolones resistance in multidrug resistant tuberculosis patients., Methods: This was a cross-sectional study conducted at a programmatic management unit of drug resistant tuberculosis, Lady Reading Hospital Peshawar, Pakistan. Two hundred and forty-three newly diagnosed multidrug resistant tuberculosis patients consecutively enrolled for treatment at study site from January 1, 2012 to July 28, 2013 were included in the study. A standardized data collection form was used to collect patients' socio-demographic, microbiological, and clinical data. SPSS 16 was used for data analysis., Results: High degree of drug resistance (median 5 drugs, range 2-8) was observed. High proportion of patients was resistant to all five first-line anti-tuberculosis drugs (62.6%), and more than half were resistant to second line drugs (55.1%). The majority of the patients were ofloxacin resistant (52.7%). Upon multivariate analysis previous tuberculosis treatment at private (OR=1.953, p=0.034) and public private mix (OR=2.824, p=0.046) sectors were predictors of ofloxacin resistance., Conclusion: The high degree of drug resistance observed, particularly to fluoroquinolones, is alarming. We recommend the adoption of more restrictive policies to control non-prescription sale of fluoroquinolones, its rational use by physicians, and training doctors in both private and public-private mix sectors to prevent further increase in fluoroquinolones resistant Mycobacterium tuberculosis strains., (Copyright © 2015 Elsevier Editora Ltda. All rights reserved.)

Objective: To assess the frequency of primary drug resistance among newly diagnosed tuberculosis cases in Karachi., Study Design: Cross-sectional study., Place and Duration of Study: Multicentric study involving various TB clinics and treatment centres of Karachi between April to December 2005., Methodology: The frequency of drug resistance among new TB patients was evaluated using a non-probability convenient sampling methodology. Sputum sample was obtained from 140 newly diagnosed sputum smear-positive patients of pulmonary tuberculosis from various centres of Karachi. Sensitivities were performed by proportion method., Results: Fifteen (11.5%) samples in 130 eligible patients showed primary resistance to one or more drugs. Ten (7.6%) of the isolates tested were resistant to a single drug, none were resistant to 2 drugs, 4 (3.0%) to 3 drugs and 1 (0.76%) to 4 drugs while 1 (0.76%) to all 5 first line agents. Resistance to streptomycin (10 microg/ml) was seen in 8 (6.1%), isoniazid (1microg/ml) in 12 (9.2%), Rifampicin (5 microg/ml) in 4 (3.0%), ethambutol (10 microg/ml) in 1 (0.76%) and pyrazinamide in 6 (4.6%) samples. Primary Multi-Drug Resistance (PMDR) was found in 2 (1.5%) patients. (Isoniazid 1 microg/ml, rifampicin 5 microg/ml with or without other drugs)., Conclusion: In the studied patients, primary drug resistance to at least one anti-tuberculosis drug was 11.5%. It requires an efficiently working anti-tuberculosis programme to prevent escalation including resistance.

Objective: To assess the prevalence of Primary drug resistance to Antituberculous drugs in NWFP METHOD: A cross-sectional prevalence study was undertaken to evaluate the prevalence of drug resistance among new TB patients, using a non-probability convenience sampling methodology. Sample size was calculated according to the population and WHO's estimated incidence of smear positive tuberculosis in the province/country. Sputum samples were obtained from 122 newly diagnosed patients of pulmonary tuberculosis from centres in Peshawar and Abbotabad in NWFP., Results: Sensitivities were performed by proportion method which showed the following resistance values in 118 eligible patients: 15 (12.7%) samples showed primary resistance to one or more drugs. 8 (6.4%) isolates were resistant to a single drug, 2 (1.6%) were resistant to 2 drugs, 4 (3.2%) to 3 drugs, 1 (0.8%) to 4 drugs while none to all 5 first line agents. Resistance to Streptomycin (10 microg/ml) was seen in 7 (5.9%), Isoniazid (1 microg/ml) in 10 (8.4%), Rifampicin (5 microg/ml) in 3 (2.5%), Ethambutol (10 microg/ml) in 2 (1.6%) and Pyrazinamide in 6 (5.0%) samples. Primary Multidrug resistance was 2.5%., Conclusion: This study suggests that prevalence of MDR amongst untreated patients in NWFP is 2.5%, which is a cause of concern and should be addressed through effective TB control programmes with DOTS strategy.