Article Text


Global problems
P2-447 Risk factors of multi-drug resistant tuberculosis (MDR TB) in Nepal
  1. S B Marahatta1,
  2. J Kaewkungwal2,
  3. P Ramasoota2,
  4. P Singhasivanon2
  1. 1Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
  2. 2Faculty of Tropical Medicine Mahidol University, Bangkok, Thailand


Introduction Multi-drug resistant (MDR) tuberculosis is defined as disease caused by Mycobacterium tuberculosis with resistance to atleast two anti-tubercular drugs isoniazid and rifampicin. Recent surveillance data have revealed that prevalence of the drug resistant tuberculosis has risen to the highest rate ever recorded in the history. The most powerful predictor of the presence of MDR-TB is a history of treatment of TB. Shortage of drugs has been one of the most common reasons for the inadequacy of the initial anti-TB regimen, especially in resource poor settings.

Method A case control study was carried out to among diagnosed MDR TB cases and Non-MDR TB cases to explore the risk factors. A total of 55 cases and 55 controls were enrolled for the study from central Nepal.

Result As per the risk factor, smoking was found to be significant (p=0.03). Likewise, history of prior tuberculosis was found to be significantly different in cases compared to control (p=0.02). Social stigma has been more pronounced among the cases compared to control (p=0.013) The knowledge regarding MDR TB and DOTS Plus treatment was found to be very high among the cases OR=9.64 (95% CI 3.34 to 27.84) and OR=16.71 (95% CI 4.65 to 60.01) respectively.

Conclusion The ultimate strategy to control MDR-TB is one that implements comprehensive approach incorporating treatment of MDR-TB based on appropriate treatment strategies that use second-line drugs under proper case management conditions; uninterrupted supply of quality-assured antituberculosis drugs; standardised recording and reporting system.

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