Abstract
Multidrug-resistant tuberculosis (MDR-TB) is a global public health threat and burden on the health system. This is especially the case in high tuberculosis (TB) prevalence countries, such as Sudan. Consequently, this study aimed to ascertain the predictors of MDR-TB in Sudan to provide future guidance. An unmatched case-control study to assess the predictors of MDR-TB infections among the Sudanese population was conducted from August 2017 to January 2018 at Abu-Anga referral hospital. Patients’ data was gathered from patients’ cards and via interviews. A structured pre-validated questionnaire was used to gather pertinent information, which included sociodemographic characteristics and other relevant clinical data. Univariate and multivariate logistic regression analysis was employed to determine the predictors of MDR-TB infection. 76 of the 183 patients interviewed (41.5%) had MDR-TB cases. The independent predictors for MDR-TB were living in rural areas [adjusted odds ratio (aOR) = 3.1 (95% confidence interval (CI): 1.2–8.2)], treatment failure [aOR = 56.9 (10.2–319.2)], and smoking [(aOR = 4 (1.2–13.2)], whereas other sociodemographic factors did not predict MDR-TB. In conclusion, the study showed that a history of smoking, living in rural areas, and a previous treatment failure were the predictors of MDR-TB in Sudan. The latter factors are most likely due to issues that are related to access and adherence to treatment and lifestyle. The existence of any of these factors among newly diagnosed TB patients should alert clinicians for the screening of MDR-TB. The implementation of directly observed treatment (DOT) and health education are crucial in stopping the spread of MDR-TB in Sudan.
Highlights
The identification and management of tuberculosis (TB) is still a priority area across countries, as it is the second leading cause of death worldwide from infectious diseases, including patients with concomitant HIV and TB [1,2,3,4]
The study showed that a history of smoking, living in rural areas, and a previous treatment failure were the predictors of multidrug-resistant tuberculosis (MDR-TB) in Sudan
The aim of this study was to identify the risk factors that are associated with MDR-TB infections in Sudan, in order to help with future management strategies and to provide guidance on the potential ways to control the spread of MDR-TB in Sudan
Summary
The identification and management of tuberculosis (TB) is still a priority area across countries, as it is the second leading cause of death worldwide from infectious diseases, including patients with concomitant HIV and TB [1,2,3,4]. In 2017, 21054 cases of TB were notified in Sudan [4]. Internal displacement enhances this high incidence of TB in Sudan [7]. Cases of multidrug-resistant tuberculosis (MDR-TB) are rising, which is a growing concern across countries [4,8,9,10,11].
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