TY - JOUR
T1 - Multidrug resistant Mycobacterium tuberculosis amongst Category I & II failures and Category II relapse patients from Pakistan
AU - Ghafoor, Abdul
AU - Mehraj, Jaishri
AU - Afridi, Nek Dad
AU - Rafiq, Yasraba
AU - Wendl-Richter, Hans Uwe
AU - Hasan, Rumina
N1 - Funding Information:
This study was funded by the German Technical Cooperation (GTZ). Funding bodies have not played any role in the design, writing or decision to publish this manuscript.
PY - 2012/9
Y1 - 2012/9
N2 - Objective: To determine the prevalence of multidrug-resistant tuberculosis (MDR-TB) among previously treated TB patients in Khyber Pakhtunkhwa (KP) Province, Pakistan. Design and settings: A cross-sectional study was conducted (January-September 2009) in 10 districts of KP. All Category (CAT) I and CAT II failures, and CAT II relapse cases were recruited within 1. week following declaration of treatment outcome or re-registration of CAT II. Clinical information and sputum was collected from each patient. Results: Total 139 patients were enrolled. Mycobacterium tuberculosis bacilli (MTB) was isolated in 113 (81.3%) samples; Mycobacterium other than tuberculosis (MOTT) was isolated in 7 (5%) samples. MDR-TB was noted in 66 (58.4%) patients and extensive drug resistant (XDR-TB) in 2 (1.8%) patients. Amongst MDR patients, 20 (62.5%) were CAT I failure, 19 (76%) CAT II failure and 27 (48.2%) CAT II relapse cases. Resistance to Isoniazid was most common in 84 (74%) cases, followed by Pyrazinamide in 73 (64.6%) cases, Rifampicin in 67 (59%) cases, Streptomycin in 60 (53%) cases, Ethambutol in 58 (51%) cases, and Ofloxacin in 18 (22.2%) cases. Conclusion: High rate of drug resistance, including MDR observed among failures and relapse cases. This study emphasizes the need to review TB care delivery, particularly in failure cases in difficult regions such as KP that have seen considerable population displacement and conflict in recent years.
AB - Objective: To determine the prevalence of multidrug-resistant tuberculosis (MDR-TB) among previously treated TB patients in Khyber Pakhtunkhwa (KP) Province, Pakistan. Design and settings: A cross-sectional study was conducted (January-September 2009) in 10 districts of KP. All Category (CAT) I and CAT II failures, and CAT II relapse cases were recruited within 1. week following declaration of treatment outcome or re-registration of CAT II. Clinical information and sputum was collected from each patient. Results: Total 139 patients were enrolled. Mycobacterium tuberculosis bacilli (MTB) was isolated in 113 (81.3%) samples; Mycobacterium other than tuberculosis (MOTT) was isolated in 7 (5%) samples. MDR-TB was noted in 66 (58.4%) patients and extensive drug resistant (XDR-TB) in 2 (1.8%) patients. Amongst MDR patients, 20 (62.5%) were CAT I failure, 19 (76%) CAT II failure and 27 (48.2%) CAT II relapse cases. Resistance to Isoniazid was most common in 84 (74%) cases, followed by Pyrazinamide in 73 (64.6%) cases, Rifampicin in 67 (59%) cases, Streptomycin in 60 (53%) cases, Ethambutol in 58 (51%) cases, and Ofloxacin in 18 (22.2%) cases. Conclusion: High rate of drug resistance, including MDR observed among failures and relapse cases. This study emphasizes the need to review TB care delivery, particularly in failure cases in difficult regions such as KP that have seen considerable population displacement and conflict in recent years.
KW - Drug resistance
KW - Pakistan
KW - Treatment failures
KW - Treatment relapses
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=84887213044&partnerID=8YFLogxK
U2 - 10.1016/j.ijmyco.2012.07.004
DO - 10.1016/j.ijmyco.2012.07.004
M3 - Article
AN - SCOPUS:84887213044
SN - 2212-5531
VL - 1
SP - 118
EP - 123
JO - International Journal of Mycobacteriology
JF - International Journal of Mycobacteriology
IS - 3
ER -
