PREVALENCE AND PATTERN OF RESISTANCE TO ANTI TUBERCULOSIS DRUGS IN OUR COMMUNITY

Abstract

OBJECTIVE: To find out prevalence of drug resistance in patients with tuberculosis.DESIGN: Descriptive cross sectional study.PLACE: Medical wards and out patient department of Civil Hospital Karachi.SAMPLE SIZE: One hundred patientsDURATION: From November 1999 to April 2001.PATIENTS AND METHODS: All the patients above 12 years of age of both sexes having sputum smear positive pulmonary tuberculosis were included in the study. A detailed clinical history, clinical examination were carried out and base line investigations including Blood CP, ESR, chest x-ray were done and sputum was inoculated for AFB culture & sensitivity. The data of each patient was collected on a separate Performa.RESULTS: In this study 100 patients were included among those 52 patients were male and 48 were female and age ranged from 16 to 68 years. Sixty four patients had Hb less than 11g%, ESR was raised in 93 patients. Chest radiographs revealed unilateral lung involvement in 56 patients while 44 patients had bilateral lung involvement. Out of 100 culture positive cases enrolled in our study 48 patients were sensitive to all four drugs tested, 16 patients were resistant to one drug, 16 were resistant to two drugs, 12 were resistant to three drugs and 8 patients were found resistant to all four drugs.CONCLUSION: In conclusion factors responsible for drug resistance seemed to be related to the patient as well as health provider. Low socioeconomic status, improper dose schedule, under dosage and lack of health education apparently seemed to be responsible for most cases of drug resistance and if the spread of drug resistance is to be halted, it looks imperative that proper attention to be paid to each of these factors and a well managed and effective national TB control program with compliance of DOTS strategy is our need today.