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Published on: September 5, 2017
Factors influencing the risk of developing multidrug-resistant pulmonary tuberculosis in Northeast Thailand
Nion Leeka1, Wongsa Laohasiriwong1, Roshan Kumar Mahato1
1Faculty of Public Health, Khon Kaen University, Khon Kaen 40002, Thailand.
Background:
This study aimed to identify the factors influencing Multidrug-Resistant Pulmonary Tuberculosis (MDR-TB) in Northeast Thailand.
Methods:
A case-control study was conducted by reviewing medical record and collecting primary data using a structured questionnaire. The study population comprised the case group of patients with MDR-TB and the control group consisted of other pulmonary tuberculosis patients aged 18 years and over with ratio 1 case: 3 controls. The factors influencing MDR-TB in the Northeast of Thailand were identified by multivariable analysis.
Results:
The results revealed that the majority of the cases and controls were males (73.79 % and 59.87 %, respectively) with mean ages of 50.50 years and 56.30 years. Cases had more moderate self-care behaviors (40.78 %) compared with controls (17.15 %). Nearly half (48.54 %) of the cases had a limited level of health literacy. Multivariable analysis demonstrated that education level (Adjusted Odd Ratio (AOR) = 1.12; 95 % CI = 1.14-1.96, p = 0.04), average monthly family income (AOR = 1.78; 95 % CI = 1.19-2.97, p = 0.01), number of windows (AOR = 2.03; 95 % CI = 1.34-3.91, p = 0.001), being diagnosed with tuberculosis two or more times (AOR = 4.63; 95 % CI = 2.51-12.35, p < 0.001), poor attitude towards tuberculosis illness (AOR = 1.32; 95 % CI = 1.05-2.48, p = 0.03), mild to moderate self-care behavior levels (AOR = 1.47; 95 % CI = 1.14-3.05, p < 0.001), and inadequate to problematic levels of health literacy (AOR = 2.11; 95 % CI = 1.36-3.63, p < 0.001) were significant determinants of MDR-TB.
Conclusions:
This study concluded that education level, monthly family income, number of windows, recurrence of TB diagnosis, attitude towards TB illness, self-care behavior level and limited health literacy level were risk factors of MDR-TB. Inadequate health literacy was particularly associated with a high risk of developing MDR-TB. In order to increase treatment success rates, the results from this study should be used to improve targeted interventions and health education strategies.
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