Infection and Disease among household contacts of Multidrug Resistant Tuberculosis Patients in Khyber Pakhtunkhwa
Keywords:
MDR-TB, Screening Program, TransmissionAbstract
Background: The emergence of multidrug-resistant tuberculosis (MDR-TB) occurs when tuberculosis bacteria develop resistance to isoniazid (INH) and rifampicin (RIF), key medications in its treatment regimen. Within communities, the risk of drugresistant strains spreading from infected individuals to others is heightened by frequent and close contact among members.Objective: This study was conducted with the aims to analyze the tuberculous infection among household contacts of MDR-TB patients.Methodology: The cross-sectional study was conducted at Programmatic Management of Drug Resistant TB Unit (PMDT), Department of Pulmonology, Lady Reading Hospital, Peshawar from January 2021 to January 2022. All such cases which were diagnosed with MDR-TB were enrolled for treatment in this center and were selected as index patients. Their contacts (spouses, children, parents, siblings and other relatives) first screened verbally and then underwent GeneXpert assay. Those found positive MTB only or MTB plus Rif resistance. Data was analyzed using IBM Statistics SPSS version 27.Results: A total of 145 enrolled MDR-TB patients were included in this study. Of these enrolled patients, a total of 1310 household contacts were analyzed for study purpose. Of these 1310 contacts, 52 (35.86%) diagnosed as tuberculosis (TB) only, while 26 (17.93%) declared as MDR-TB. The most frequents symptoms among these household were fever, cough, and chest pain.Conclusion: It is imperative to explore diverse strategies for managing and breaking the chain of tuberculosis (TB) and multidrug-resistant tuberculosis (MDRTB). Household contacts screening emerges as a pivotal component in this effort.The present research has revealed that 35.86% of individuals were found to be infected solely with Mycobacterium tuberculosis (MTB), while 17.93% were identified as having MDR-TB.References
World Health Organization. Global Tuberculosis Control 2011. Geneva, Switzerland: WHO; 2011.
Mandelbaum-Schmid J. The global plan to stop TB 2011-2015: transforming the fight towards elimination of tuberculosis 2011.
Naidoo P, Mwaba KJ. Helplessness, depression and social support among TB patients at a public health site: a prevalence study. J Soc Beh Pers. 2010;38(10):1323-34.
Iqbal Z, Khan MA, Aziz A, Nasir SM. Time for culture conversion and its associated factors in multidrug-resistant tuberculosis patients at a tertiary level hospital in Peshawar, Pakistan. Pak J Med Sci. 2022;38(4Part-II):1009.
Iqbal Z, Batool R, Khan MA, Ali SZ, Asif M. Predictors of Unsuccessful Interim Treatment Outcomes and Culture Conversion among Multidrug Resistant Tuberculosis Patients in Pakistan. IJONS. 2021;64(11):29253-64.
Khan MA, Aziz A, Ullah U, Ullah N, Jan F, Nasir SM, Javaid A. Treatment outcomes of short course regimens for multidrug-resistant tuberculosis patients in Peshawar. Pak J Chest Med. 2020;26(4):210-6.
Rieder HL. Contacts of tuberculosis patients in high-incidence countries. Int J Tuberc Lung Dis. 2003;7(12):S333-6.
Greenaway C, Palayew M, Menzies D. Yield of casual contact investigation by the hour. Int J Tuberc Lung Dis. 2003;7(12):S479-85.
Fok A, Numata Y, Schulzer M, FitzGerald MJ. Risk factors for clustering of tuberculosis cases: a systematic review of population-based molecular epidemiology studies. Int J Tuberc Lung Dis. 2008;12(5):480-92.
Kenyon TA, Valway SE, Ihle WW, Onorato IM, Castro KG. Transmission of multidrug-resistant Mycobacterium tuberculosis during a long airplane flight. N Engl J Med. 1996;334(15):933-8.
Yim JJ, Selvaraj P. Genetic susceptibility in tuberculosis. Respirology. 2010;15(2):241-56.
Suggaravetsiri P, Yanai H, Chongsuvivatwong V, Naimpasan O, Akarasewi P. Integrated counseling and screening for tuberculosis and HIV among household contacts of tuberculosis patients in an endemic area of HIV infection: Chiang Rai, Thailand. Int J Tuberc Lung Dis. 2003;7(12):S424-31.
Marks SM, Taylor Z, Qualls NL, Shrestha-Kuwahara RJ, Wilce MA, Nguyen CH. Outcomes of contact investigations of infectious tuberculosis patients. Am J Respir Crit Care Med. 2000;162(6):2033-8.
World Health Organization. Systematic screening for active tuberculosis: principles and recommendations. World Health Organization; 2013.
Moonan PK, Nair SA, Agarwal R, Chadha VK, Dewan PK, Gupta UD, et al. Tuberculosis preventive treatment: the next chapter of tuberculosis elimination in India. BMJ Global Health. 2018;3(5):e001135.
Morrison J, Pai M, Hopewell PC. Tuberculosis and latent tuberculosis infection in close contacts of people with pulmonary tuberculosis in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2008;8(6):359-68.
Atre SR, Kudale AM, Morankar SN, Rangan SG, Weiss MG. Cultural concepts of tuberculosis and gender among the general population without tuberculosis in rural Maharashtra, India. Trop Med Int Health. 2004;9(11):1228-38.
Singla N, Singla R, Jain G, Habib L, Behera D. Tuberculosis among household contacts of multidrug-resistant tuberculosis patients in Delhi, India. Int J Tuberc Lung Dis. 2011;15(10):1326-30.
Barroso EC, Mota RM, Pinheiro VG, Campelo CL, Rodrigues JL. Occurrence of active tuberculosis in households inhabited by patients with susceptible and multidrug-resistant tuberculosis. J Bras Pneumol. 2004;30:311-8.
Morrison J, Pai M, Hopewell PC. Tuberculosis and latent tuberculosis infection in close contacts of people with pulmonary tuberculosis in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2008;8(6):359-68.
Rieder HL. Contacts of tuberculosis patients in high-incidence countries. Int J Tuberc Lung Dis. 2003;7(12):S333-6.
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