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Prevalence of multi-drug resistant tuberculosis in Karachi, Pakistan: identification of at risk groups

Muslima Ejaz1, Amna Rehana Siddiqui, Yasraba Rafiq

  • 1Department of Pathology and Microbiology, Aga Khan University, Stadium Road, Karachi, Pakistan.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|April 30, 2010
PubMed

Insights

Multidrug-resistant tuberculosis (MDR-TB) affects 5.0% of patients in Karachi. Female gender and prior incomplete treatment are significant risk factors for MDR-TB, highlighting the need for targeted prevention strategies.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Multidrug-resistant tuberculosis (MDR-TB) poses a significant global health threat.
  • Pakistan has a high tuberculosis prevalence but lacks data on drug-resistant TB.
  • Understanding MDR-TB prevalence and risk factors is crucial for effective control strategies.

Purpose of the Study:

  • To estimate the prevalence of multidrug-resistant tuberculosis (MDR-TB) in Karachi.
  • To identify risk factors associated with MDR-TB in patients with pulmonary tuberculosis.

Main Methods:

  • A study involving 640 adult patients with pulmonary tuberculosis was conducted in Karachi from July 2006 to August 2008.
  • Passive case finding was employed, and MDR-TB prevalence was calculated using Epi-Info.
  • Logistic Regression analysis was used to determine risk factors associated with MDR-TB.

Main Results:

  • The overall prevalence of MDR-TB was 5.0% (95% CI: 3.3-6.6%), with higher rates in previously treated patients (17.9%) compared to untreated patients (2.3%).
  • Independent risk factors for MDR-TB included female gender (OR 3.12) and a history of incomplete treatment (OR 10.1).
  • Specific ethnic groups, Sindhis (OR 4.5) and Pashtoons (OR 3.6), showed higher risk for MDR-TB.

Conclusions:

  • The study established a 5.0% MDR-TB rate in the studied population in Karachi.
  • There is a critical need to enhance MDR-TB prevention efforts.
  • Strategies should include strengthening Directly Observed Treatment, Short-course (DOTS) delivery, with a focus on women and high-risk ethnic groups.

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