Prevalence and Risk Factors Associated with Multidrug-resistant Tuberculosis in Specimens at The Office of Disease Prevention and Control, Region 10 Ubon Ratchathani

Abstract

Multidrug-resistant tuberculosis (MDR-TB) remains a significant global public health concern due to its complexity in treatment and potential for transmission. Early identification of individuals at risk is crucial for timely diagnosis and effective control of the disease. Although several studies have reported various MDR-TB risk factors in different regions, no prior research has comprehensively assessed this issue within the jurisdiction of the Office of Disease Prevention and Control, Region 10, Ubon Ratchathani, Thailand. This cross-sectional analytical study aimed to examine the prevalence and risk factors associated with MDR-TB in specimens submitted for testing between fiscal years 2021 and 2023. A total of 8,168 samples positive for Mycobacterium tuberculosis were analyzed, of which 212 were confirmed as MDR-TB. Data were analyzed using descriptive statistics and inferential methods, including odds ratios (OR), 95% confidence intervals (CI), and Fisher’s exact test, with statistical significance set at p<0.05. The findings revealed that the prevalence of MDR-TB during 2021–2023 was 2.86%, 1.83%, and 2.99%, respectively, with an average prevalence of 2.60%. The most frequently observed pattern of first-line drug resistance was mono-resistant tuberculosis (Mono-resistant TB), particularly isoniazid-resistant tuberculosis (Hr-TB), which refers to Mycobacterium tuberculosis strains resistant to isoniazid alone. The annual prevalence rates of Hr-TB were 6.44%, 7.92%, and 7.97% for the fiscal years 2021, 2022, and 2023, respectively, with an average prevalence of 7.43%. and showing an increasing trend. Significant risk factors associated with MDR-TB included a history of previous TB treatment (p<0.001), contact with TB patients (p=0.013), diabetes mellitus (p=0.049), and smoking (p=0.046). Notably, individuals with a prior history of TB treatment had a 5.97 times greater risk of developing MDR-TB compared to those without such history (OR=5.970, 95% CI=4.504–7.916). These results highlight the urgent need to implement proactive surveillance measures targeting high-risk populations, including previously treated TB patients, close contacts of TB cases, individuals with diabetes, and smokers. The incorporation of molecular diagnostic method for rapid detection of resistance to isoniazid and rifampicin is recommended to enhance early identification and appropriate management of MDR-TB cases. These efforts align with the World Health Organization’s End TB Strategy, which emphasizes effective and sustainable TB control at both national and global levels.