The Epidemiological Study and Risk Factors of Drug-Resistant Tuberculosis In Samut Sakhon Province, Thailand
Keywords:
drug-resistant tuberculosis, risk factorAbstract
Objective: Study the epidemiology of pulmonary, extrapulmonary and disseminated tuberculosis, prevalence of drug resistant tuberculosis and its risk factors in Samut Sakhon Province.
Material and Methods: A descriptive, retrospective, cross-sectional, analytic review was conducted. Data from Tuberculosis Case Management Program (TBCM) registry were collected from October 1, 2016 to September 30, 2017. The incidence and treatment outcomes of pulmonary TB, disseminated TB and extrapulmonary TB (EPTB), and prevalence of drug-resistant pulmonary TB (DR-PTB) were described. Multivariate analysis with logistic regression for odds ratio was performed to determine possible risk factors for drug-resistant pulmonary tuberculosis.
Results: Of the total 581 cases of tuberculosis, mean age was 39.4 ± 13.7 years old. 375 were male (64.5%). There were 449 (77%), 98 (17%), and 34 (6%) cases of pulmonary, extrapulmonary, and disseminated tuberculosis respectively. Of all, 507 (87.3%) were new cases, 370 (63.7%) were Thais. Most of non-Thais were Myanmars (203 cases, 34.3%). 98 were HIV infected (16.9%). Of the tuberculosis with pulmonary involvement, the incidences of isolated isoniazid-resistant (HR-PTB) and rifampicin-resistant/multidrug-resistant pulmonary tuberculosis (RR/MDR-PTB) were 10.2% and 6.8% respectively. Prevalence of primary RR/MDR-PTB was 3.8%. Positive HIV status was a significant risk factor for developing any DR-PTB (OR 2.83, 95%CI 1.20-6.65, p 0.017). Mortality rate among any DR-PTB was higher than that of drug-susceptible pulmonary tuberculosis (OR 5.21, 95%CI 2.16- 12.54, p < 0.001. The strongest predictor for disseminated tuberculosis was positive HIV status (OR 25.42, 95%CI 10.69-60.43). While non-Thai nationality was not a risk factor for DR-PTB, they had higher propensity to be transferred out to other public health facilities (OR 4.81, 95% CI 2.46 - 9.40, p < 0.001).
Conclusion: Prevalence of DR-PTB in Samut Sakhon Province was higher than an average of Thailand. Its risk factor was positive HIV status. Immigrants were not a risk factor for developing DR-PTB but they had a higher transfer-out rate than that of Thai people.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
