PREVALENCE OF DRUG RESISTANCE IN PULMONARY TUBERCULOSIS

Abstract

OBJECTIVE: To determine the prevalence of primary and secondary drug resistance to first line anti-tuberculous drugs. STUDY DESIGN: A hospital-based cross-sectional observational study. PLACE AND DURATION: Department of Medicine Liaquat University Hospital Hyderabad/ Jamshoro & Institute of Chest Diseases Kotri from April 2005 to March 2007. PATIENTS AND METHODS: Fifty cases of Pulmonary tuberculosis (TB) randomly selected from both institutes who fulfilled the following criteria 1) Sputa showed positive smear for Acid Fast bacilli on Zeil Nelson Stain.2) Chest x-ray showed shadow consistent with TB. A detailed history, contact with TB patients, previous use of anti-tuberculous drugs and Chest x-ray was done. Sputa of all patients were sent for detail report and culture sensitivity. Descriptive and inferential statistical analysis was performed using SPSS version 14.0. RESULTS: Among 50 patients, 28(56%) were males and 22(44%) females, age ranged from 16-80 years (38.14 + 15.69). All 50 (100%) patients presented with fever and cough, haemoptysis in 36 (72%), chest pain in 9(18%) and dyspnea in 11(22%) cases, anemia in 39(78%) and lymphadenopathy in 12(24%). On chest x-ray examination, 19(38%) patients had multiple infiltrations, cavitations in 10(20%), fibrosis in 9(18%), consolidation in 5(10%), pneumothorax in 4(8%) and pleural effusion in 3(6%) cases. Sputum for AFB was positive in all cases. Twenty-one (42%) culture positive patients were of primary resistance and 29(58%) were of secondary resistance. Twenty (40%) were sensitive to five drugs, 9(18%) resistant to one drug, 11(22%) to two drugs, 7 (14%) to three drugs, 3(6%) to four drugs and none resistant to five drugs. CONCLUSION: In our setting, the prevalence of resistance to anti-tuberculous drugs is high and alarming. Strategy should be made for proper treatment and compliance of patients to avoid the development of drug resistance.