Determinants of multidrug-resistant tuberculosis in Henan province in China: a case control study

• Published in: BMC public health 2016-01, Vol.16 (45), p.42-42, Article 42
• Main Authors: Zhang, Chunxiao, Wang, Yongliang, Shi, Guangcan, Han, Wei, Zhao, Huayang, Zhang, Huiqiang, Xi, Xiue
• Format: Article
• Language: English
• Subjects: Adult; Alcoholism; Care and treatment; Case-Control Studies; China - epidemiology; Community health care; Control methods; Control programs; Data collection; Developing Countries; Diagnosis; Drug resistance; Drug sensitivity testing; Education; Ethics; Female; Forecasts and trends; Health care facilities; Health facilities; Health services; Health Services Accessibility; Hospital facilities; Hospitals; Humans; LDCs; Logistic Models; Male; Marital status; Medical records; Methods; Middle Aged; Mortality; Multidrug resistance; Multidrug resistant organisms; Opportunist infection; Patients; Public health; Public health administration; Regression analysis; Regression models; Risk analysis; Risk Factors; Sensitivity enhancement; Sex Factors; Smoking - epidemiology; Social Stigma; Sociodemographics; Socioeconomic Factors; Statistical analysis; Tuberculosis; Tuberculosis, Multidrug-Resistant - epidemiology; Tuberculosis, Multidrug-Resistant - psychology
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-016-2711-z

Multi-drug resistance (MDR) has been a cause of concern for tuberculosis (TB) control in both developed and developing countries. This study described the characteristics and risk factors associated with MDR-TB among 287 cases and 291 controls in Henan province, China. A hospital-based case-control study was conducted between June 2012 and December 2013. The study subjects were selected using multistage probability sampling. Multivariate conditional logistic regression models were used to determine the risk factors associated with MDR-TB. The following risk factors for MDR-TB were identified: previous TB treatment (AOR = 4.51, 95% CI: 3.55-5.56), male sex (AOR = 1.09, 95% CI: 0.24-1.88), high school or lower education degree (AOR = 1.87, 95% CI: 1.27-2.69), unemployment (AOR = 1.30, 95% CI: 0.78-2.52), long distance of residence from the health facility (AOR = 6.66,95% CI: 5.92-7.72), smoking (AOR = 2.07, 95% CI: 1.66-3.19), poor knowledge regarding MDR-TB (AOR = 2.06, 95% CI: 1.66-2.92), traveling by foot to reach the health facility (AOR = 1.85, 95% CI: 1.12-3.09), estimated amount of time to reach the health facility was greater than 3 h (AOR = 1.42, 95% CI: 0.51-2.35), social stigma (AOR = 1.17, 95% CI: 0.27-2.03), having an opportunistic infection (AOR = 1.45, 95% CI: 0.58-2.4), more than 3 TB foci in the lungs (AOR = 1.98, 95% CI: 1.49-3.25), total time of first treatment was more than 8 months (AOR = 1.39, 95% CI: 0.65-2.54), adverse effects of anti-TB medication (AOR = 2.39, 95% CI: 1.40-3.26), and more than 3 prior episodes of anti-TB treatment (AOR = 1.83, 95% CI: 1.26-2.80). The identified risk factors should be given priority in TB control programs. Additionally, there is a compelling need for better management and control of MDR-TB, particularly through increasing laboratory capacity, regular screening, enhancing drug sensitivity testing, novel MDR-TB drug regimens, and adherence to medication.