Abstract
Introduction: The increase in cases of drug-resistant pulmonary tuberculosis, especially in endemic areas, is mainly associated with re-treatment, although resistant tubercle bacilli can be easily transmitted between all susceptible persons. Objective: The study aimed to describe pulmonary tuberculosis, risk factors and MDR in new and re-treated suspected patients attending Wad Madani Tuberculosis Center that provides service in central Sudan. Methods: Cross-sectional laboratory based study among 300 presumptive pulmonary tuberculosis patients during 2018 and 2019 was conducted. Cases were divided into new and re-treated. Mycobacterium tuberculosis DNA and rpoB gene of multi-drug resistance (MDR) were detected in sputum samples by GeneXpert assay as manufacturer instructions. Results: Out of 300 suspected participants, 34% (103/300) were diagnosed as pulmonary tuberculosis using GeneXpert method. The frequency of males, the age group from 21 to 40 and rural housing were the most with percentage reach 68% (70/103), 51% (53/103) and 58.3% (60/103) respectively. All observed symptoms were significantly associated with pulmonary tuberculosis. New cases represented 59.2% (61/103) while re-treated was 40.8% (39/103). The overall frequency of MDR patients was 9.7% (10/103) of which 50% (5/103) had relapse situation. Conclusion: It appeared that the cases of MDR pulmonary tuberculosis are on the increase compared to previous findings, recommended measures must be taken to control the spread of tuberculosis and the causes of re-treatment and relapse must be studied.
Highlights
The increase in cases of drug-resistant pulmonary tuberculosis, especially in endemic areas, is mainly associated with re-treatment, resistant tubercle bacilli can be transmitted between all susceptible persons
Risk factors of acquiring TB could be categorized into factors that related to susceptible person and contact situation, this includes: age, sex, HIV confection, diabetes, immunosuppressive drugs medications, renal failure, alcohol intake
According to WHO Sudan classified as country with medium prevalence for diabetes [7] which is another risk factor for acquiring tuberculosis, in adult a percentage 7.7% had been reported as prevalence rate in Sudan [8]
Summary
The increase in cases of drug-resistant pulmonary tuberculosis, especially in endemic areas, is mainly associated with re-treatment, resistant tubercle bacilli can be transmitted between all susceptible persons. Objective: The study aimed to describe pulmonary tuberculosis, risk factors and MDR in new and re-treated suspected patients attending Wad Madani Tuberculosis Center that provides service in central Sudan. During the time period from 2006 to 2015, Sudan recorded an increasing in cases of tuberculosis in both new and resistant cases, which indicates the absence or ineffectiveness of control measures for limiting the spread [1]. Risk factors of acquiring TB could be categorized into factors that related to susceptible person and contact situation, this includes: age, sex, HIV confection, diabetes, immunosuppressive drugs medications, renal failure, alcohol intake. While risk factors related to drug resistance occurring include failure, relapse, and loss of follow-up [4]. According to WHO Sudan classified as country with medium prevalence for diabetes [7] which is another risk factor for acquiring tuberculosis, in adult a percentage 7.7% had been reported as prevalence rate in Sudan [8]
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