Infection and Drug Resistance (Aug 2020)
Rifampicin-resistant Mycobacterium tuberculosis by GeneXpert MTB/RIF and Associated Factors Among Presumptive Pulmonary Tuberculosis Patients in Nepal
Abstract
Shiv Kumar Sah,1 Pramod Raj Bhattarai,2 Anjana Shrestha,3 Deepak Dhami,3 Deepa guruwacharya,3 Renu Shrestha3 1Little Buddha College of Health Science, Purbanchal University, Minbhawan, Kathmandu, Nepal; 2National Tuberculosis Control Center, Bhaktapur, Nepal; 3Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, NepalCorrespondence: Shiv Kumar SahPurbanchal University, Little Buddha College of Health Science, Minbhawan, Kathmandu, NepalEmail [email protected]: Mycobacterium tuberculosis(MTB) remains a major public health problem worldwide, and emergence of drug-resistant TB has become a significant obstacle to effective TB control. However, the rate of MTB and rifampicin resistant-MTB (RR-MTB) in the Nepalese setting has not been studied extensively. Therefore, the present study aims to assess the rate of MTB and RR-MTB and further determine the factors associated with it.Methods: A retrospective cross-sectional study, among national representative data of 990 consecutive presumptive TB resister of patients subjected to the GeneXpert test that presented to the tuberculosis referral hospital, was conducted over a one year period from February 2018 to January 2019. Significance for the difference for categorical data was performed by Chi-square test and factors associated with MTB and RR-MTB were assessed using binary logistic regression yielding OR with 95%CI.Results: Of total 990 presumptive tuberculosis analyzed cases, median ages of the patients were 39± 19.09 years and two-thirds of the patients were male 653 (66.0%). The estimated prevalence of MTB in presumptive TB patients was 13.8% (95%CI: 11.88%– 16.16%), and risk for MTB was significantly associated with previously treated patients: OR: 10.4 (P< 0.001). The estimated prevalence of RR-MTB in MTB confirmed patients was 10.2% (4.97%– 15.1%). Our study confirmed no association of RR-TB with age, sex, ethnicity, geographical diversity and previous history of treatment failure (P> 0.05).Conclusion: The overall prevalence of MTB and RR-MTB was high in Nepalese study population, and that being previously treated with anti-TB drug remained significant predictors for MTB; proactive measures are urgently needed to address the challenge of prompt diagnosis, early management and improved monitoring of treatment to limit the emergence drug-resistant MTB strains in the community.Keywords: MTB prevalence, RR-MTB prevalence, risk factors, Nepal
