Previous treatment, sputum-smear nonconversion, and suburban living: The risk factors of multidrug-resistant tuberculosis among Malaysians

Noorsuzana Mohd Shariff, Shamsul Azhar Shah, Fadzilah Kamaludin

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

The number of multidrug-resistant tuberculosis patients is increasing each year in many countries all around the globe. Malaysia has no exception in facing this burdensome health problem. We aimed to investigate the factors that contribute to the occurrence of multidrug-resistant tuberculosis among Malaysian tuberculosis patients. An unmatched case-control study was conducted among tuberculosis patients who received antituberculosis treatments from April 2013 until April 2014. Cases are those diagnosed as pulmonary tuberculosis patients clinically, radiologically, and/or bacteriologically, and who were confirmed to be resistant to both isoniazid and rifampicin through drug-sensitivity testing. On the other hand, pulmonary tuberculosis patients who were sensitive to all first-line antituberculosis drugs and were treated during the same time period served as controls. A total of 150 tuberculosis patients were studied, of which the susceptible cases were 120. Factors found to be significantly associated with the occurrence of multidrug-resistant tuberculosis are being Indian or Chinese (odds ratio 3.17, 95% confidence interval 1.04-9.68; and odds ratio 6.23, 95% confidence interval 2.24-17.35, respectively), unmarried (odds ratio 2.58, 95% confidence interval 1.09-6.09), living in suburban areas (odds ratio 2.58, 95% confidence interval 1.08-6.19), are noncompliant (odds ratio 4.50, 95% confidence interval 1.71-11.82), were treated previously (odds ratio 8.91, 95% confidence interval 3.66-21.67), and showed positive sputum smears at the 2nd (odds ratio 7.00, 95% confidence interval 2.46-19.89) and 6th months of treatment (odds ratio 17.96, 95% confidence interval 3.51-91.99). Living in suburban areas, positive sputum smears in the 2nd month of treatment, and was treated previously are factors that independently contribute to the occurrence of multidrug-resistant tuberculosis. Those with positive smears in the second month of treatment, have a history of previous treatment, and live in suburban areas are found to have a higher probability of becoming multidrug resistant. The results presented here may facilitate improvements in the screening and detection process of drug-resistant patients in Malaysia in the future.

Original languageEnglish
Pages (from-to)51-58
Number of pages8
JournalInternational Journal of Mycobacteriology
Volume5
Issue number1
DOIs
Publication statusPublished - 1 Mar 2016

Fingerprint

Multidrug-Resistant Tuberculosis
Sputum
Odds Ratio
Confidence Intervals
Tuberculosis
Malaysia
Therapeutics
Pulmonary Tuberculosis
Pharmaceutical Preparations
Isoniazid
Rifampin
Case-Control Studies
Health

Keywords

  • Multidrug resistant
  • Risk factors
  • Tuberculosis

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Previous treatment, sputum-smear nonconversion, and suburban living : The risk factors of multidrug-resistant tuberculosis among Malaysians. / Mohd Shariff, Noorsuzana; Shah, Shamsul Azhar; Kamaludin, Fadzilah.

In: International Journal of Mycobacteriology, Vol. 5, No. 1, 01.03.2016, p. 51-58.

Research output: Contribution to journalArticle

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abstract = "The number of multidrug-resistant tuberculosis patients is increasing each year in many countries all around the globe. Malaysia has no exception in facing this burdensome health problem. We aimed to investigate the factors that contribute to the occurrence of multidrug-resistant tuberculosis among Malaysian tuberculosis patients. An unmatched case-control study was conducted among tuberculosis patients who received antituberculosis treatments from April 2013 until April 2014. Cases are those diagnosed as pulmonary tuberculosis patients clinically, radiologically, and/or bacteriologically, and who were confirmed to be resistant to both isoniazid and rifampicin through drug-sensitivity testing. On the other hand, pulmonary tuberculosis patients who were sensitive to all first-line antituberculosis drugs and were treated during the same time period served as controls. A total of 150 tuberculosis patients were studied, of which the susceptible cases were 120. Factors found to be significantly associated with the occurrence of multidrug-resistant tuberculosis are being Indian or Chinese (odds ratio 3.17, 95{\%} confidence interval 1.04-9.68; and odds ratio 6.23, 95{\%} confidence interval 2.24-17.35, respectively), unmarried (odds ratio 2.58, 95{\%} confidence interval 1.09-6.09), living in suburban areas (odds ratio 2.58, 95{\%} confidence interval 1.08-6.19), are noncompliant (odds ratio 4.50, 95{\%} confidence interval 1.71-11.82), were treated previously (odds ratio 8.91, 95{\%} confidence interval 3.66-21.67), and showed positive sputum smears at the 2nd (odds ratio 7.00, 95{\%} confidence interval 2.46-19.89) and 6th months of treatment (odds ratio 17.96, 95{\%} confidence interval 3.51-91.99). Living in suburban areas, positive sputum smears in the 2nd month of treatment, and was treated previously are factors that independently contribute to the occurrence of multidrug-resistant tuberculosis. Those with positive smears in the second month of treatment, have a history of previous treatment, and live in suburban areas are found to have a higher probability of becoming multidrug resistant. The results presented here may facilitate improvements in the screening and detection process of drug-resistant patients in Malaysia in the future.",
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