Prevalence of Pre-XDR-TB and XDR-TB among MDR-TB patients

Abstract

Background: Tuberculosis (TB) still remain a challenge to health authorities through out the world. It is most dangerous in the form of drug resistant TB (DRTB). Programmatic management is need of the day to stop the transmission and conversion of susceptible TB into DR-TB. Present study was conducted to evaluate the prevalence of pre-extensively drug resistant tuberculosis (Pre-XDR), extensively drug resistant tuberculosis (XDR) among the MDR-TB patients.Methodology: We reviewed the record of all patients registered inPMDT site at Nishtar Medical hospital, Multan, Pakistan between June 2012and March 2016. Data was obtained about clinical details and resistancepattern.Results: A total of 531 patients were enrolled during this period. 295 (55.5%) were male and 236 (44.5%) were female. Most of the patients 377/531 (71%) belong to younger age group i.e from 15-44. The prevalence rate of Pre-XDR and XDR-TB among MDR TB patients were 171/531 (32.2%) and 18/531 (3.4%) respectively. Out of 18 XDR-TB patients 10 were resistant to Amikacin (Am), Kanamycin (Km), Capreomycin (Cm) and Fluoroquinolone (FQ). 05 were resistant to Km+FQ. 02 were resistant to Am+Km+FQ and 01 patient was resistant to Cm+FQ. Out of 171 PRE-XDR TB patients all were found to be resistant toFQand no one was resistant to 2nd line Injectibles (Am,Km,Cm).Conclusion: There is high prevalence of Pre-XDR tuberculosis in patientsregistered at PMDT site, at Nishtar Medical hospital, Multan, PakistanPakistan. Similarly XDR-TB patients were also reported and registered during this time period. There is a desperate need to closely follow new TB patients and to emphasize on treatment compliance in order to prevent drug resistant tuberculosis. There is also a need to ban over the counter sale of Anti Tuberculous Drugs especially second line drugs.