Characteristics of Multidrug Resistance Tuberculosis Cases in Baghdad

*Bacteriologist,Ph.D,Al-Kindey College of Medicine. **Community Medicine Specialist, Specialized Center for Chest and Respiratory Disease. ***Pulmonologist ,Internist, Specialized Center for Chest and Respiratory Disease. ****Pulmonologist ,Specialized Center for Chest and Respiratory Disease. INTRODUCTION: The emergence of drug resistance in the course of treatment for tuberculosis (TB) is a phenomenon that was recognized shortly after the introduction of streptomycin in 1946–1947. Acquired drug resistance in TB patients is largely an iatrogenic ABSTRACT: BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is caused by strains of Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin, the two most effective bactericidal agents currently available for TB treatment.It has emerged as a global public health emergency . It requires treatment with combination therapy consisting of four to six medications for up to 2 years . Additionally, the treatment is generally more toxic and far more expensive than the standardized treatment regimen used to treat drug-susceptible TB . The latest estimates of the World Health Organization (WHO) arrive at 650 000 prevalent MDR-TB cases among the 12 million tuberculosis cases worldwide. OBJECTIVE: To identify the Characteristics of multidrug resistance tuberculosis cases attending the specialized center for chest and respiratory disease in Baghdad during the period 9 th of September 2012 – 9 th of December 2012. METHODS : A cross sectional study was done in the specialized center for chest and respiratory disease in Baghdad during the period 9 th of September 2012 – 9 th of December 2012.Any patient attending the specialized center for chest and respiratory disease in Baghdad during the study period diagnosed as a case of MDR TB was enrolled in this study. RESULTS: The sample is composed of 42 MDR-TB patients (29 male and 13 female ) , with age mean of 38.3±12.8 year . Male sex significantly dominates and exceeds two thirds of the sample (69.0%) (P < 0.05). The study find ages between 25-45 year contribute to about two thirds (62.0%) of patients, and ages between 55-65 years constitute about one fifth (19.0%) of the sample. (P < 0.05). Body habit significantly showed that half the sample (50.0%) were underweight and only 10% were overweight or obese (P < 0.05). Smoking is found in 21.4% of total sample. The duration of taking first line antituberculosis drugs (FLD) before being labeled as MDR-TB varied from 14 to 72 months, with mean duration of 27.3±15.2 months with no significant difference in mean duration between the two sexes (P > 0.05,). Time required to diagnose these cases as MDR-TB varied from 0 to 24 months with mean time of 9.0±6.5 months. There was no significant difference in mean diagnosis time between males and females (P > 0.05). This study found that around one fifth (19.0%) of the sample have a history of default from treatment with FLD. Only one female was significant to be a case of primary MDR-TB (P > 0.05). Two cases (both were males) significantly had history of reaction to FLD treatment (P < 0.05). None of the sample had positive HIV testing. CONCLUSION: Most MDR patients in this study were males aged between 25-45 years . Most cases had acquired MDR TB and primary MDR-TB was rare finding in this study. Around one fifth of the sample have a history of default from treatment with FLD.