Forhad Akhtar Zaman1, Vijay Kumar Mehta2, Shraddha Deokota3
BACKGROUND
Tuberculosis (TB) is a curable and preventable disease. Emergence of multi drug
resistance TB (MDR TB) threatens to undo the progress made towards control of
TB. While treatment is available for MDR TB, it is of a long duration and is also
more expensive and toxic. Understanding the various factors that are associated
with MDR TB may help to formulate and implement effective preventive practices
for control of MDR TB. We wanted to assess the various epidemiological factors
among MDR TB cases registered under Revised National Tuberculosis Control
Programme (RNTCP) in East Sikkim and study the current & past TB treatment
including adverse drug reactions.
METHODS
A community-based case control study was conducted over 4 months in the
eastern district of Sikkim. MDR TB cases registered under Revised National
Tuberculosis Control Programme (RNTCP) in the first two quarters of 2019 were
compared with matched healthy controls. Data was collected by a door to door
survey using a pre-designed and pre-tested questionnaire and analysed on
Statistical Package for the Social Sciences (SPSS) 20.
RESULTS
A total of 62 cases (14 non-respondents) of MDR TB were identified and were
matched with 63 controls. 30.5 % cases were young adults in the age group 15
to 25 years, 66 % of the cases reported being currently unemployed, 16 % were
homemakers, 11 % of cases fell below poverty line. A higher proportion of cases
as compared to controls reported a habit of skipping a meal, poor housing
conditions and comorbidities than controls. A known history of contact with a case
of tuberculosis was given by 11.3 % cases; 18 % cases gave a previous history of
TB; about 51 % cases reported a delay in diagnosis which delayed treatment
initiation.
CONCLUSIONS
Previous history of TB with history of relapse / failure, contact of MDR TB emerged
as the most significant risk factors and presence of comorbid conditions like
diabetes & hypertension can be used to indicate higher risks of drug resistance.
