Multidrug resistant tuberculosis: prevalence and risk factors in districts of metema and west armachiho, Northwest Ethiopia.

Feleke Mekonnen,Gemechu Kumera,Setegn Eshetie,Belay Tessema,Aschalew Gelaw,Feleke Moges

doi:10.1186/s12879-015-1202-7

Abstract

BackgroundMulti drug resistant tuberculosis (MDR-TB) is an emerging challenge for TB control programs globally. According to 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.MethodsA 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 possible risk 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 using the proportional method on LJ media. Data were analyzed using statistical Package SPSS version 20; binary logistic regression was used to assess the association. P-values < 0.05 were considered as statistically significant.ResultsOf 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 significantly associated risk factor for MDR-TB.ConclusionThe overall prevalence of MDR-TB was 5.7 % among cases at five health centers and a history of previous treatment was found to be a risk factor for being infected by an MDR-TB strain. Therefore, 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.

Highlights

Multi drug resistant tuberculosis (MDR-TB) is an emerging challenge for TB control programs globally
Emerging and spread of drug resistance TB has encountered as a great challenge in Africa region, Sub-Saharan Africa in particular
A total of 124 smear positive tuberculosis patients were included from five different heath centers in West Armachiho and Metema districts

Summary

Introduction

Multi drug resistant tuberculosis (MDR-TB) is an emerging challenge for TB control programs globally. According to World health organization, 2012 report Ethiopia stands 15th out of the 27 high priority countries in the world and 3rd in Africa. Even more, according WHO 2014 report, the morbidity and mortality rate were increased by 400,000 and 200,000 cases, respectively, with reference to the previous WHO report [2]. Sub-Saharan Africa stands the burden of both very high TB incidence and the highest HIV prevalence rates in the world, and represents 14 % of the global burden of new MDR-TB cases [3]

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