Abstract

Title : DRUG RESISTANCE IN SMEAR-POSITIVE PULMONARY TUBERCULOSIS PATIENTS IN UBON RATCHATHANI PROVINCE
By : WANPEN WATTHANAARMORNKIET
Degree : MASTER OF SCIENCE
Major : HEALTH SERVICE MANAGEMENT
Advisor : DAYIN KOOMPALUM
Keywords : = SMEAR-POSITIVE PULMONARY TUBERCULOSISPATIENTS /DRUG RESISTANCE
   
The objectives of this cross-sectional research were to explore the prevalence of multi-drug resistance (MDR) and factors associated with MDR in all smear-positive Tuberculosis patients in the registry at Ubon Ratchathani during October 1st, 2004 to September 30th, 2006. Sputum culture and drug susceptibility test (DST) were performed in every patient before starting treatment regimens; Provider-Initiated Counseling and Testing (PICT) for HIV infection was also given. Standard record forms adapted from national TB program and active TB surveillance were used. Descriptive analysis was used to analyze demographic data and drug susceptibility results. Bivariate analysis, Chi-square, and Odds ratio with 95% confident interval were performed to identify factors associated with MDR. The results showed that, from the registry, 2,154 were positive with smear test. Among these, 90% were new cases. Sputum cultures were performed in 1,782 cases and 87.04% had a positive result. Of those 1,551, 1,403 cases were positive with sputum culture and DST. Nine hundred and eighty two were male. The average age was 50.516.4 years old. 3.64% of patients had MDR. MDR in new cases was 1.49% whereas MDR in cases previously treated for Tuberculosis was 25%. The average age of patients with MDR was statistically different from that of patients without MDR (p-value =0.005). Factors statistically associated with MDR were HIV-infection (OR=2.61, p-value=0.004), history of previous TB treatment (OR=22.04, p-value=0.001) and registering for treatment at provincial hospital (OR=2.75, p-value=0.001). Gender, intravenous drug use, diabetic mellitus and resident location were not associated with MDR. Thus, to prevent and control future MDR-TB problem, high-quality care for new TB patients and effective MDR-TB surveillance should be established.
   
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