Aim The aim of this study was to estimate the prevalence,
possible risk factors, patterns of resistance, and fate of
multidrug-resistant pulmonary tuberculosis (MDR-TB) in
Alexandria governorate as a representative part of Egypt
during the period between July 2008 and December 2012.
Patients and methods This retrospective study included
all patients with pulmonary TB that was recorded in
Alexandria governorate during the period between July
2008 (the time that MDR ward was held in Alexandria) and
December 2012. They were divided into two groups: group
I included patients with pulmonary TB that was recorded
in Alexandria governorate (1893 cases), and group II
included patients with pulmonary TB who were admitted
in El-Maamoura Chest Hospital (509 cases). They were
subdivided into two subgroups: group IIa included patients
with MDR pulmonary TB (82 cases), and group IIb included
patients with pulmonary TB not categorized as MDR-TB
(427 cases).
Results All patients with MDR-TB had acquired resistance.
MDR-TB was more common in the male population,
diabetic patients, and those with chronic chest disease. The
effect of treatment of MDR-TB cases was as follows: cured
patients, 49 (59.8%); patients under treatment, 10 (12.2%);
treatment failure, four cases (4.9%); deceased patients,
10 (12.2%); and defaulters, nine (10.9%). The overall total
prevalence rate of MDR-TB in Alexandria governorate from
2008 to 2012 was 4.3%.
Conclusion There was a decreasing trend of MDR-TB cases.
History of anti-TB treatment is the strongest independent
predictor of MDR-TB. The highest figures of resistance in
the MDR group besides isoniazide and rifampicin were
for streptomycin, whereas the lowest resistance was for
ethambutol. |
