Investigation of Drug-Resistant Tuberculosis in Kaeng Khro district from October 2018 to August 2019

Abstract

Between October, 2018 and August, 2019 Kaeng Khro Hospital found 6 new case of drug-resistant tuberculosis (TB) patients. From 2015 to 2018, there were only 4 cases of drug-resistant TB in Kaeng Khro district. So the author began investigated the incidence to assess whether this incidence was cluster infection or not. Methods: A cross-sectional study was performed. Assessed all 6 patients clinical characteristic from hospital database then surveyed the environment. Results: It is suspected this incidence was not cluster infection. Three patients which were 1st, 3rd and 5th cases had hometown in Khok Kung sub-district, but they lived in different communities. The 1st patient had Isoniazid-resistant TB while another 2 had multidrug-resistant TB (MDR-TB). The 3rd patient developed symptom in July, 2018 in Chonburi province but the 5th developed symptom in April, 2018 while lived in Kaeng Khro. Another 3 patients had MDR-TB and lived in different sub-districts. Three patients have diabetes type 2 and could not control sugar level well which increased the risk of drug-resistant TB. It is suspected that all 6 patients had primary drug-resistant TB caused by infection while staying in other areas. Three of them might suffer from secondary drug-resistant TB caused by delayed diagnosis or poor adherence. If there were new case of drug-resistant TB in the same area or being a close contact person in this study we will promptly send Line probe assay in case of sputum AFB positive or Sputum gene Xpert in case of sputum AFB negative in the first diagnosis. Conclusion: We suspected this incidence was not the cluster infection. We already has measures to early detect the new case of drug-resistant TB by sending investigation to find evidence of drug-resistant TB in the first diagnosis.