Top

BMC Public Health

Published in:

Open Access 01-12-2015 | Research article

Drug resistance patterns of Mycobacterium tuberculosis complex and associated factors among retreatment cases around Jimma, Southwest Ethiopia

Authors: Kedir Abdella, Ketema Abdissa, Wakjira Kebede, Gemeda Abebe

Published in: BMC Public Health | Issue 1/2015

Abstract

Background

Information on the pattern of drug resistant tuberculosis (TB) among re-treatment cases is crucial to develop appropriate control strategies. Therefore, we conducted this study to assess the drug resistance pattern of M. tuberculosis complex (MTBC) isolates and associated factors among re-treatment cases in Jimma area, Southwest Ethiopia.

Methods

Health facility-based cross-sectional study was conducted between March 2012 and April 2013 in Jimma area, Southwest Ethiopia. We included 79 re-treatment cases selected conveniently. Socio demographic and clinical data were collected using structured questionnaire. Sputum sample processing, mycobacterial culture, isolation and drug susceptibility testing (DST) were done at Mycobacteriology Research Centre (MRC) of Jimma University. All data were registered and entered in to SPSS version 20. Crude odds ratio (COR) and adjusted odds ratios (AOR) were calculated. P-values less than 0.05 were considered statistically significant.

Results

Seventy-nine re-treatment cases included in the study; 48 (60.8 %) were males. Forty- seven (59.5 %) study participants were from rural area with the mean age of 31.67 ± 10.02 SD. DST results were available for 70 MTBC isolates. Majority (58.6 % (41/70)) isolates were resistant to at least one of the four first line drugs. The prevalence of multidrug-resistant TB (MDR-TB) was 31.4 % (22/70). Place of residence (AOR = 3.44 (95 % CI: 1.12, 10.60), duration of illness (AOR = 3.00 (95 % CI: 1.17, 10.69) and frequency of prior TB therapy (AOR = 2.99, (95 % CI: 1.01, 8.86) were significant factors for any drug resistance. Moreover, history of treatment failure was found to be associated with MDR-TB (AOR = 3.43 (95 % CI: 1.14, 10.28).

Conclusion

The overall prevalence of MDR-TB among re-treatment cases around Jimma was high. The rate of MDR-TB was higher in patients with the history of anti-TB treatment failure. Timely identification and referral of patients with the history of treatment failure for culture and DST need to be strengthened.

Karlson GA, Lessel EF. Mycobacterium bovis. Nom Nov Int J Sys Bacteriol. 1970;20:273–82.CrossRef

World Health Organization. Global tuberculosis Control report 2010. Available at http://reliefweb.int/sites/reliefweb.int/files/resources/F530290AD0279399C12577D8003E9D65-Full_Report.pdf. Accessed on March 25, 2012

World Health Organization. Global tuberculosis report. Switzerland: Geneva 27; 2014.

Federal Democratic Ripublic of Ethiopia Minstry of Health. First Ethiopian National Population Based Tuberculosis Prevalence Survey. Ethiopia: Addis Ababa; 2011.

GBC-Health. Drug-resistant-TB:-why-it-matters. availble at: http://www.gbchealth.org/system/documents/category_1/7/GBCHealth%20Issue%20Brief_Drug-Resistant%20TB.pdf. Accessed on March 25, 2012.

Mak A, Thomas A, DelGranado M, Zaleskis R, Mouzafarova N, Menzies D. Influence of Multidrug Resistance on Tuberculosis Treatment Outcomes with Standardized Regimens. Am J Respir Crit Care Med. 2008;178:306–12.CrossRefPubMed

Berhan A, Berhan Y, Yizengaw D: A meta-analysis of drug resistanttuberculosis in Sub-Saharan Africa: how strongly associated with previous treatment and HIV co-infection? Ethiop JHealth Sci, 23(3):271-282.

Anthony SF. Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis: The National Institute of Allergy and Infectious Diseases Research Agenda and Recommendationsfor Priority Research. J of Inf Dis. 2008;197:1493–8.CrossRef

Falzon D, Jaramillo E, Schünemann HJ, Arentz M, Bauer M, Bayona J, et al. WHO guidelines for the programmatic management of drug-resistant tuberculosis: 2011 update. Eur Respir J. 2011;38(3):516–28.CrossRefPubMed

10.

World health organization. Guidelines for surveillance of drug resistance in tuberculosis-4th ed. WHO/HTM/TB/2009.422. Geneva, Switzerland: World Health Organization; 2009.

11.

Zhang Y, Yew WW. Mechanisms of drug resistance in Mycobacterium tuberculosis. Int J Tuberc Lung Dis. 2009;13(11):1320–30.PubMed

12.

Canneti G, Fox W, Khomenko A. Advances in techniques of testing mycobacterial drug sensitivity, and the use of sensitivity tests in tuberculosis programmes. Bull World Health Organ. 1969;41:21–43.

13.

Meskel DW, Abate G, Lakew M, Goshu S, Aseffa A. Anti-tuberculosis drug resistance among retreatment patients seen at St Peter Tuberculosis Specialized Hospital. Ethiop Med J. 2008;46(3):219–25.PubMed

14.

Abate D, Taye B, Abseno M, Biadgilign S. Epidemiology of anti-tuberculosis drug resistance patterns and trends in tuberculosis referral hospital in Addis Ababa, Ethiopia. BMC Res Notes. 2012;5:462.

15.

Jones-López EC, Ayakaka I, Levin J, Reilly N, Mumbowa F, Dryden-Peterson S, et al. Effectiveness of the standard WHO recommended retreatment regimen (category II) for tuberculosis in Kampala, Uganda: a prospective cohort study. Plos Med. 2011;8(3):e1000427.CrossRefPubMedPubMedCentral

16.

Hanif M, Malik S, Dhingra VK. Acquired drug resistance pattern in tuberculosis cases at the state tuberculosis centre, Delhi. India Int J Tuberc Lung Dis. 2009;13(1):74–8.PubMed

17.

Abate G, Miörner H, Ahmed O, Hoffner SE. Drug resistance in Mycobacterium tuberculosis strains isolated from re-treatment cases of pulmonary tuberculosis in Ethiopia: susceptibility to first-line and alternative drugs. Int J Tuberc Lung Dis. 1998;2:580–4.PubMed

18.

Jenkins HE, Zignol M, Cohen T. Quantifying the burden and trends of isoniazid resistant tuberculosis-1994-2009. PLoS ONE. 2011;6:7.

19.

Gillespie SH. Evolution of Drug resistance in Mycobacterium tuberculosis: Clinical and molecular perspective. Antimicrob Agents Chemother. 2002;46:267.CrossRefPubMedPubMedCentral

20.

World Health Organization. International Union against Tuberculosis and Lung Disease. Anti-tuberculosis drug resistance in the world: 4th global report. available at: http://www.who.int/tb/publications/2008/drs_report4_26feb08.pdf. Accessed on March 25, 2012. 2008.

21.

Hoek KG, Schaaf HS, van Pittius NC, van Helden PD, Warren RM. Resistance to pyrazinamide and ethambutol compromises MDR/XDR-TB treatment. SAMJ. 2009;99:785-87.

22.

Temple B, Ayakaka I, Ogwang S, Nabanjja H, Kayes S, Nakubulwa S, et al. Rate and Amplification of Drug Resistance among Previously-Treated Patients with Tuberculosis in Kampala. Uganda Clin Infec Dis. 2008;47(9):1126–34.CrossRef

23.

Gler MT, Macalintal LE, Raymond L, Guilatco R, Quelapio MI, Tupasi TE. Multidrug-resistant tuberculosis among previously treated patients in the Philippines. Int J Tuberc Lung Dis. 2011;15:652–6.CrossRefPubMed

24.

Merza MA, Farnia P, Tabarsi P, Khazampour M, Masjedi MR, Velayati AK. Anti-tuberculosis drug resistance and associated risk factors in a tertiary level TB centre in Iran: A retrospective analysis. J Infect Dev Ctries. 2011;5:511–9.CrossRefPubMed

25.

Liang L, Wu Q, Gao L, Hao Y, Liu C, Xie Y, et al. Factors contributing to the high prevalence of multidrug-resistant tuberculosis: a study from China. Thorax BMJ. 2012;67(7):632–8.CrossRef

26.

Migliori GB, Dheda K, Centis R, Mwaba P, Bates M, O’Grady J, et al. Review of multidrug-resistant and extensively drug-resistant TB: global perspectives with a focus on sub-Saharan Africa. Trop Med Int Health. 2010;15(9):1052–66.CrossRefPubMed

27.

Sharma SK, Kumar S, Saha PK, George N, Arora SK, Gupta D, et al. Prevalence of multidrug-resistant tuberculosis among Category II pulmonary tuberculosis patients. Indian J Med Res. 2011;133:312–5.PubMedPubMedCentral

28.

Abebe G, Abdissa K, Abdissa A, Apers L, Agonafir M, de-Jong BC, et al. Relatively low primary drug resistant tuberculosis in southwestern Ethiopia. BMC Res Notes. 2012;5:225.CrossRefPubMedPubMedCentral

Title: Drug resistance patterns of Mycobacterium tuberculosis complex and associated factors among retreatment cases around Jimma, Southwest Ethiopia
Authors: Kedir Abdella
Ketema Abdissa
Wakjira Kebede
Gemeda Abebe
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-015-1955-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Drug resistance patterns of Mycobacterium tuberculosis complex and associated factors among retreatment cases around Jimma, Southwest Ethiopia

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2015

Mortality in the German Pharmacoepidemiological Research Database (GePaRD) compared to national data in Germany: results from a validation study

Recency and frequency of HIV testing among men who have sex with men in Germany and socio-demographic factors associated with testing behaviour

Effectiveness of the population health and environment approach in improving family planning outcomes in the Gurage, Zone South Ethiopia

Health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia: a systematic literature review of qualitative and quantitative data

Smoking behaviors before and after implementation of a smoke-free legislation in Guangzhou, China

The association between the parental perception of the physical neighborhood environment and children’s location-specific physical activity