Risk Factors of Drug Resistance among Tuberculosis Patients of Prakasam District, Andhra Pradesh, India

Abstract

Introduction: India is leading in the burden of Tuberculosis (TB) according to the new report of the World Health Organisation (WHO) on the disease. Multi-Drug Resistant TB (MDR-TB) cases have been increasing in India. About half of the world’s MDR-TB cases are present in India. Aim: To assess the incidence of drug resistant TB in Prakasam district, Andhra Pradesh, India, in the second quarter of the year 2019 and to determine the risk factors that are responsible to develop drug resistance to anti-tubercular drugs in the study population. Materials and Methods: A Community based cross-sectional study was conducted from April 1st to June 30th in Prakasam district, Andhra Pradesh. All the registered drug resistant TB cases in Prakasam district who gave consent during the study period were taken as sample. The diagnosed drug resistant TB patients were interviewed and proportions of different variables were calculated and chi-square test was used to test significance of results. Results: Out of 209 TB patients, 88 patients were having drug resistant TB in Prakasam district. Prevalence of Drug resistant TB in Prakasam district was calculated as 5.64 per one lac population. In the second quarter of the year 2019-2020, i.e., from April 1st to June 30th, 88 new cases were identified. Incidence of Drug resistant TB in Prakasam district was calculated as 2.38 per one lac population. Male persons (76%), having the age 20-40 years (42%), 40-60 (38.7%) belonging to middle class (45.5%) and migrating for work (85%) are at more risk of developing drug resistant TB. Most of the patients are developing drug resistant TB directly (70.5%) which is an alarming signal. The rifampicin resistant patients were also developing psychological complications (22). Drug toxicity was observed in 55% of the cases. Conclusion: Incidence of drug resistant TB was more in male persons, above 20 years of age, belonging to middle class socio-economic status and migrating for work. Most of the patients developed drug resistant TB directly without previous history of TB. Drug toxicity was observed in half of the cases. Psychological complications were observed in rifampicin resistant patients. Surveillance activity should be addressed properly to combat the risk factors.