Prevalence and pattern of Multidrug resistant tuberculosis among retreatment (Category II) patients of pulmonary tuberculosis in Khyber Pakhtunkhwa, Pakistan

Abstract

Background: Resistance to first-line drugs is a major issue in tuberculosis (TB) control. Globally 20% of previously treated TB cases have been reported to have multi-drug resistant tuberculosis (MDR-TB). Pakistan is among the top high TB burden countries with an annual incidence of 270 per 100,000 and estimated to have more than 13000 MDR-TB cases. In the province of Khyber Pakhtunkhwa (KPK) the annual incidence of TB is around 55,000 out of which around 5% are retreatment cases. So a survey was needed to determine the prevalence of MDR-TB in KPK.Objectives: Objective of the present study was to find out the prevalence of MDR-TB among previously treated (Category II) pulmonary tuberculosis patients in the province of Khyber Pakhtunkhwa, Pakistan.Methodology: A total of 131 cultures positive retreatment patients wereincluded in this cross-sectional study. Drug susceptibility testing withIsoniazid, Rifampicin, Streptomycin, Ethambutol, and Pyrazinamide wereperformed with the standard technique.Results: Of the 131 patients, 54 (41.2%) showed resistance to one or more drugs. Resistance with isoniazid and rifampicin [MRD-TB] was seen in 20 patients (15.3%). Resistance to streptomycin was highest (31.3%), followed by isoniazid (26.0%).Conclusion: The result of this study showed the prevalence of drug resistance of 41.2% and MDR-TB of 15.3% with the first line ATT among retreatment cases of pulmonary tuberculosis.