Predictors of multidrug-resistant tuberculosis (MDR-TB) in Sudan

Ali, Monadil H. and Alrasheedy, Alian A. and Hassali, Mohamed Azmi Ahmad and Kibuule, Dan and Godman, Brian (2019) Predictors of multidrug-resistant tuberculosis (MDR-TB) in Sudan. Antibiotics, 8 (3).

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    Abstract

    Multidrug-resistant tuberculosis (MDR-TB) is a global public health threat and burden on the health system. This is especially the case in high TB prevalence countries such as Sudan. Therefore, this study aimed to ascertain the predictors of MDR-TB in Sudan to provide future guidance. An unmatched case-control study to assess the predictors of MDR-TB infections among the Sudanese population was conducted from August 2017 to January 2018 at Abu-Anga referral hospital. Patients’ data was gathered from patients’ cards and via interviews. A structured pre-validated questionnaire was used to gather pertinent information including sociodemographic characteristics and other relevant clinical data. Univariate and multivariate logistic regression analysis was employed to determine predictors of MDR-TB infection. Of the 183 patients interviewed, 76 (41.5%) had MDR-TB cases. The independent predictors for MDR-TB were living in rural areas [adjusted odds ratio (aOR) = 3.1 (95% confidence interval (CI): 1.2–8.2)], treatment failure [aOR = 56.9 (10.2 – 319.2)], and smoking [(aOR = 3.9 (1.2 – 13.2)], whereas other sociodemographic factors did not predict MDR-TB. In conclusion, the study showed that a history of smoking, living in rural areas, and a previous treatment failure were the predictors of MDR-TB in Sudan. The latter factors are most likely due to issues related to access and adherence to treatment and lifestyle. The existence of any of these factors among newly diagnosed TB should alert clinicians for the screening of MDR-TB. Implementation of directly observed treatment (DOT) and health education are crucial to stopping the spread of MDR-TB in Sudan.