Risk factors of multi-drug-resistant tuberculosis among tuberculosis patients in Bagmati Province, Nepal: a matched...

Drug-resistant tuberculosis poses a significant threat to global TB control efforts, potentially reversing progress made in reducing TB-related morbidity and mortality. This study aims to identify risk factors for multidrug-resistant TB [MDR-TB] in Bagmati Province, Nepal.

This study employed a matched case-control design to identify risk factors for multidrug-resistant tuberculosis (MDR-TB) in Bagmati Province, Nepal. Conducted in Kathmandu, Bhaktapur, and Chitwan, cases were MDR-TB patients from authorized treatment centers, while controls were patients with non-MDR-TB from Directly Observed Treatment, Short-course (DOTS) centers. A total of 154 participants were included, with 77 cases and 77 controls matched by gender. Data was collected through face-to-face interviews by a trained professional, with stringent COVID-19 safety measures in place. Statistical analysis was performed using SPSS, involving descriptive statistics and binary logistic regression to identify significant predictors of MDR-TB. Ethical approval was obtained from BP Koirala Institute of Health Sciences, and informed consent was secured from all participants.

A total of 154 patients (77 cases,77 controls) were interviewed, and the study found significant associations between pulmonary TB and the case group (89.6%) compared to controls (57.1%) (p < 0.001; OR: 6.5; 95% CI: 2.7-15.2), indicating it as a substantial risk factor. Controls showed higher rates of Extra Pulmonary TB (42.9%) compared to cases (10.4%). Previous TB history was more prevalent among cases (63.6%) than controls (10.4%) (p < 0.001; OR: 15.09; 95% CI: 6.34-35.91), highlighting it as a significant risk factor. Cases were more likely to report close contact with TB patients (64.9%) compared to controls (32.5%) (p < 0.001; OR: 3.85; 95% CI: 1.97-7.51). Cases also had a significant association with close contact with drug-resistant TB patients (p = 0.001; OR: 78; 95% CI: 10.31-589.62), suggesting exposure as a risk factor.

The study findings revealed significant risk factors for MDR-TB, including Pulmonary Tuberculosis [PTB], previous TB treatment history, and close contact with DR-TB patients. The study highlights the importance of prevention measures to break transmission chains and infection control in health facilities.