DISTRIBUTION OF DR-TB BY SEX, AGE GROUPS, OCCUPATION, PROVINCE, DIVISION, DISTRICT, TYPE OF DISEASE, TYPE OF DRUG RESISTANCE, TREATMENT REGIMEN AND OUTCOME OF TREATMENT IN DR-TB POPULATION IN D.I.KHAN DIVISION, PAKISTAN

Zeeshan Saleem; Imran Ullah; Muhammad Sarim Bin Farooq Awan; Jamal Tauqir; Faisal Younis; Nisar Khan; Muhammad Hamza Riaz; Huzaifa Tahir Saeed Siddiqui; Asim Alam; Noman Ullah; Muhammad Asif; Muhammad Arif; Sadeeq Ahmad; Hamza Shafiq; Sohail Ahmad Meer; Rahmail Khan; Muhammad Ayub

doi:10.46903/gjms/18.03.897

DISTRIBUTION OF DR-TB BY SEX, AGE GROUPS, OCCUPATION, PROVINCE, DIVISION, DISTRICT, TYPE OF DISEASE, TYPE OF DRUG RESISTANCE, TREATMENT REGIMEN AND OUTCOME OF TREATMENT IN DR-TB POPULATION IN D.I.KHAN DIVISION, PAKISTAN

Zeeshan Saleem, Imran Ullah, Muhammad Sarim Bin Farooq Awan, Jamal Tauqir, Faisal Younis, Nisar Khan, Muhammad Hamza Riaz, Huzaifa Tahir Saeed Siddiqui, Asim Alam, Noman Ullah, Muhammad Asif, Muhammad Arif, Sadeeq Ahmad, Hamza Shafiq, Sohail Ahmad Meer, Rahmail Khan, Muhammad Ayub

Abstract

Background: Drug-resistant tuberculosis (DR-TB) is the major cause of mortality worldwide. Our objectives were to determine the distribution of DR-TB by sex, age groups, occupation, province, division, district, type of disease, type of drug resistance, treatment regimen and outcome of treatment in DR-TB population in D.I.Khan Division, Pakistan.

Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan. A sample of 286 DR-TB patients was selected consecutively from population at risk. Sex, age groups, occupation, province, division and district were demographic while type of disease, type of drug resistance, treatment regimen and outcome of treatment were research variables. All variables being nominal were described by count, percentage & cumulative percentage with 95% confidence interval for proportion. Distribution of DR-TB patients by all the ten variables were substantiated by chi-square goodness-of-fit test.

Results: Out of 286 DR-TB patients, 123 (43%) were men and 163 (57%) women. DR-TB cases were most prevalent in age group 15-44 years 172 (60.14%), housewife 140 (48.95%), Khyber Pakhtunkhwa 175 (61.19%), D.I.Khan Division 178 (62.24%) and district 121 (42.31%). Most common type of disease, drug resistance and treatment regimen was pulmonary TB 282 (98.60%), MDR 273 (95.45%) and longer treatment (n=273 MDR-TB) 246 (90.11%) respectively. Treatment success rate was 161 (56.29%). The observed prevalence by occupation, province, division, district and type of disease in our sample was similar to expected prevalence in population (p>.05 for all), while it was different from population by sex, age groups, type of drug resistance, regimen and treatment outcome (p<.05 for all).

Conclusion: The prevalence of DR-TB was higher in women, age group 15-44 years, housewife, Khyber Pakhtunkhwa and D.I.Khan Division and District. Most common type of disease, drug resistance and treatment regimen was pulmonary TB, MDR and longer treatment respectively. Treatment success rate was 56.29%. The observed prevalence by occupation, province, division, district and type of disease in sample was similar to population, while it was different by sex, age groups, type of drug resistance, regimen and treatment outcome.

Keywords

Tuberculosis; Pulmonary Tuberculosis; Drug-Resistant Tuberculosis, Multidrug-Resistant Tuberculosis; MDR Tuberculosis; Extensively Drug-Resistant Tuberculosis; XDR-TB; Drug Resistance; Multidrug Resistance.

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References

WHO. Global tuberculosis report 2019. World Health Organization. Geneva [accessed 2020 Dec 8]. Available at: https://www.who.int/tb/publications/global_report/en/

National TB Control Program. National guidelines for control of tuberculosis in Pakistan [revised and updated 2019, cited 2020 Apr 24]. Available at: http://ntp.gov.pk/ntp-old/uploads/National_Guidelines_for_TB_Revised_2019

Worku Y, Getinet T, Mohammed S, Yang Z. Drug-resistant tuberculosis in Ethiopia: characteristics of cases in a referral hospital and the implications. Int J Microbacteriol [serial online] 2018 [cited 2020 May 11]; 7:167-72. https://doi.org/10.4103/ijmy.ijmy_48_18

He XC, Zhang XX, Zhao JN, Liu Y, Yu CB, Yang GR, et al. Epidemiological trends of drug-resistant tuberculosis in China from 2007 to 2014: a retrospective study. Medicine (Baltimore) [serial online] 2016 Apr [cited 2020 May 11]; 95(15): e3336. https://doi.org/10.1097/MD.0000000000003336

Johnston JC, Shahidi NC, Sadatsafavi M, Fitzgerald JM. Treatment outcomes of multidrug-resistant tuberculosis: a systematic review and meta-analysis. PLoS ONE [serial online] 2009 [cited 2020 May 11]; 4(9): e6914. https://doi.org/10.1371/journal.pone.0006914

Venkatesh U, Srivastava DK, Srivastava AK, Tiwari HC. Epidemiological profile of multidrug-resistant tuberculosis patients in Gorakhpur Division, Uttar Pradesh, India. J Family Med Prim Care [serial online] 2018 May-Jun [cited 2020 May 11]; 7(3): 589-95. https://doi.org/10.4103/jfmpc.jfmpc_99_17

Hasan R, Jabeen K, Ali A, Rafiq Y, Laiq R, Malik B, et al. Extensively drug-resistant tuberculosis in Pakistan. Emerg Infect Dis [serial online] 2010 Sep [cited 2020 May 11]; 16(9): 1473-5. https://doi.org/10.3201/eid1609.100280

Ahmad N, Javed A, Sulaiman SAS, Ming LC, Ahmad I, Khan AH. Resistance patterns, prevalence, and predictors of fluoroquinolone resistance in multidrug resistant tuberculosis patients. Braz J Infect Dis [serial online] 2016 Jan-Feb [cited 2020 May 13]; 20(1):41-7. https://doi.org/10.1016/j.bjid.2015.09.011

Alene KA, Yi H, Viney K, McBryde ES, Yang K, Bai L, et al. Treatment outcomes of patients with multidrug-resistant and extensively drug resistant tuberculosis in Hunan Province, China. BMC Infect Dis [serial online] 2017 [cited 2020 May 14]; 17:573. https://doi.org/10.1186/s12879-017-2662-8

Wahab F, Ashraf S, Khan N, Anwar R, Afridi MZ. Risk factors for multi-drug resistant tuberculosis in patients at tertiary care hospital, Peshawar. J Coll Physicians Surg Pak [cited 2020 May 14] 2009 Mar; 19(3):162-4. doi: 03.2009/JCPSP.162164

Akhtar AM, Arif MA, Kanwal S, Majeed S. Prevalence and drug resistance pattern of MDR TB in retreatment cases of Punjab, Pakistan. J Pak Med Assoc 2016 Aug; 66(8):989-93.

Javaid A, Hasan R, Zafar A, Chaudry MA, Qayyum S, Qadeer E, et al. Pattern of first- and second-line drug resistance among pulmonary tuberculosis retreatment cases in Pakistan. Int J Tuberc Lung Dis 2017 Mar 1; 21(3):303-8. https://doi.org/10.5588/ijtld.16.0444

WHO. TB disease burden: Companion handbook to the WHO guidelines for the programmatic management of drug-resistant tuberculosis. WHO, Geneva. WHO Document Production Services 2014.p.27-70.

Raosoft® sample size calculator. [accessed 2020 May 14]. Available at: http://www.raosoft.com/samplesize.html

Statistics Kingdom. Proportion confidence interval calculator [internet]. Statistics Kingdom; Melbourne, Australia 2007. [accessed 2020 May 07]. Available at: http://www.statskingdom. com/41_proportion_confidence_interval.html

Zar JH. Biostatistical Analysis. 5th ed. New York: Prentice-Hall, Inc.

Daniel WW. Biostatistics: A Foundation for Analysis in the Health Sciences. 7th ed. Singapore: John Wily; 2005.

Jeremy Stangroom. Chi-Square Test Calculator. Social Science Statistics. [accessed 2020 Apr 24]. Available at: https://www.socscistatistics. com/tests/chisquare2/Default2.aspx

Statistics Kingdom. Chi-Square test calculator [internet]. Statistics Kingdom; Melbourne, Australia 2007. [accessed 2020 May 07]. Available at: https://www.statskingdom.com/310GoodnessChi.html

Shah S, Basharat A, Shah M, Marwat M, Billah M, Ali SM. Frequency, distribution and presentation n of hypocalcemia in ß-thalassemia major. Gomal J Med Sci 2018; 16:2-8. https://doi.org/10.46903/gjms/16.01.1446

Ghori MR, Khan H, Marwat M. Distribution of non-malignant hematological disorders by sex, age groups and type of disease based on bone marrow aspiration in population of Khyber Pa-khtunkhwa, Pakistan. Gomal J Med Sci 2019 Apr-Jun; 17 (2): 29-36. https://doi.org/10.46903/gjms/17.02.1926

Butt M, Rehman MU, Khan AR, Abrar A. Frequency of triple-vessel coronary artery disease in adult type 2 diabetics versus non-diabetics in coronary artery disease population of Islamabad, Pakistan. Gomal J Med Sci 2019 Apr-Jun; 17(4).37-41. https://doi.org/10.46903/gjms/17.02.2029

Ain N, Khan S, Marwat M, Khan N, Ahmad I, Ramzan F, et al. Frequency, distribution and determinants of hypertension in adult stroke population of D.I.Khan Division, Pakistan. Gomal J Med Sci 2019 Jul-Sep; 17 (3):81-9. https://doi.org/10.46903/gjms/17.03.2076

Akhtar A, Ali SM, Naqi SA, Aziz T, Shinwari W, Shah SFH. Efficacy of acetic acid versus ciprofloxacin ear drops in achieving dry ears in chronic suppu¬rative otitis media in adult population of Islamabad, Pakistan: a non-randomized control trial. Gomal J Med Sci 2019 Jul-Sep; 17 (3): 90-94. https://doi.org/10.46903/gjms/17.03.2007

Marwat M, Ahmad I, Ashiq F, Ali S, Zamir S, Rehman MU, et al. Frequency, distribution and determinants of diabetes mellitus in adult acute coronary syndrome population of D.I.Khan Division, Pakistan. Gomal J Med Sci 2019 Oct-Dec; 17 (4):131-43. https://doi.org/10.46903/gjms/17.04.2106

Khan A, Khan MI, Ali MA, Hussain A, Ibrahim M, Muhammad T. Sex and age wise distribution, presentation and successful removal and mortality of foreign body aspiration using rigid bronchoscope in children of District D.I.Khan, Pakistan. Gomal J Med Sci 2020 Jan-Mar; 18 (1):3-11. https://doi.org/10.46903/gjms/18.01.1949

Khalid MK, Ahmad I, Khan MA, Sharjeel M, Irfan M. Marwat M. Distribution of pediatric cataracts by sex, age groups, laterality, type and presentation in population of D.I.Khan District, Pakistan. Gomal J Med Sci 2019 Oct-Dec; 17 (3):123-30. https://doi.org/10.46903/gjms/17.04.2025

DOI: https://doi.org/10.46903/gjms/18.03.897

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Copyright (c) 2020. Zeeshan Saleem, Imran Ullah, Muhammad Sarim Bin Farooq Awan, Jamal Tauqir, Faisal Younis, Nisar Khan, Muhammad Hamza Riaz, Huzaifa Tahir Saeed Siddiqui, Asim Alam, Noman Ullah, Muhammad Asif, Muhammad Arif, Sadeeq Ahmad, Hamza Shafiq, et al.