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Abstrakt
Drug Resistance Pattern of Mycobacterium tuberculosis in Eastern Amhara Regional State, Ethiopia
Ahmed Esmael, Ibrahim Ali, Mulualem Agonafir, Mengistu Endris, Muluworke Getahun, Zelalem Yaregal and Kassu Desta
Background: Tuberculosis (TB) is a major public health problem in Amhara region, Ethiopia where the TB case detection rate is low (22%). This situation has been worsened by the emergence and spread of drug resistance strains which have been threatening efforts of TB control. Objectives: The aim of this study was to assess the magnitude of drug resistance patterns of M. tuberculosis in Eastern Amhara region, Ethiopia. Methods: A facility based cross sectional study was conducted among 230 (165 new and 65 retreated) smear positive TB patients (age ≥18 years old) from September 2010 to June 2011. Socio-demographic data of the study participants and possible factors for development of drug resistance were collected using pre-tested structured questionnaire. Smear positive sputum samples were processed and decontaminated by the modified Petrof method. Primary isolation and drug susceptibility testing (DST) were carried out on egg based Lowenstein –Jensen media (LJ). Data were entered and analyzed using SPSS version 16 software. Multivariate analysis using the logistic regression model was computed. P-values less than 0.05 were considered as statistically significant. Results: The overall prevalence of drug resistance to at least a single drug was 77/230(33.5%). The prevalence of MDR-TB in all, new and re-treated patients was 15/230(6.5%), 3/165(1.8%) and 12/65 (18.5%), respectively. In the multivariate analysis previous exposure to anti-TB drugs and 1+ bacterial load were significantly associated with anti TB drug resistance (P<0.05). Conclusion: A high rate of drug resistance for main anti-tuberculosis drugs was observed on new and previously treated cases. Previous exposure to anti-TB drugs and bacterial load were important determinants of development of drug resistance. So, patient’s adherence to anti-TB drugs (especially re-treated cases) and scaling up of DST service at district hospital level will help to reduce the development of drug resistance in the study area.