Rifampicin and INH monoresistance prevalence among Iraqi smear positive pulmonary tuberculosis cases

Abstract

Background: Tuberculosis is one of the most deadly diseases.Yearly 9 million people develop TB and 1.5 million die from TB.INH and rifampicin are the cornerstone of treatment regimens for TB,loss of any of them will affect treatment outcomes and TB control program Objective: Find the prevalence of Rifampicin and INH monoresistance among pulmonary cases Methods: A longitudinal study targeted all new smear positive and retreated pulmonary TB cases for the first time from 50 randomly selected clusters (from 19 health directorates), during the period from November 2013 to October 2014. In each cluster a 26 smear-positive cases were expected to be enrolled .Sputum smear negative TB and extra-pulmonary TB cases were excluded. Drug susceptibility testing-DST was requested for all samples. SPSS V20 was used for analysis. Results: This study enrolled 1160 patients. DST was done for 1029 patients, 59.9 % susceptible to all anti-TB drug, 17.7 monoresistance to any anti-TB drug, 2.3% INH monoresistance , 2.7% rifampicin monoresistance ,3.3% MDR and the rest were polyresistance . In INH/Rifampicin monoresistance-IR/RR group male/female ratio was 0.8, while in the susceptible group it was 1.27, 3.2% of susceptible group were asthmatic and no asthmatic was found in IR/RR group, regarding distribution of the two groups according to age, residence area, education level, smoking history and house hold contact to TB case there was no significant difference 15.5% of IR/RR group were previously treated with anti TB drug in comparison to 10.6% in susceptible group Conclusion: prevalence of Rifampicin and INH monoresistance among new and previously treated smear positive pulmonary TB cases is 5 % in Iraq.