Original Research

Treatment Strategies in Defaulters Among MDR TB Patients

Rizwan Iqbal1
PHRC TB Research Centre
Muhammad Kashif Munir1
PHRC TB Research Centre
Sana Rehman1
PHRC TB Research Centre
Saqib Saeed2
Department of Pulmonology, King Edward Medical University, Lahore

✉ Correspondence: Muhammad Kashif Munir Email: munir_gemini81@gmail.com

DOI https://doi.org/10.70302/jpsim.v2i1.2106
Volume: 2, Issue 1 Pages: 19–23 Published: 13 Mar 2021
Received: 26 Nov 2020 Accepted: 03 Jan 2021 Published Online: 13 Mar 2021

Abstract

Background

: Tuberculosis is a chronic disease and the most common cause of death while drug resistance in TB is a serious health issue throughout the world. Individuals with MDR TB treatment defaulters are focused with least priority due to number of administrative, low socioeconomic and resource issues.

Methods

This exploratory observational study was undertaken by Pakistan Health Research Council, TB Research Centre from July 2017 to April 2018 in collaboration with Department of Pulmonology, King Edward Medical University/Mayo Hospital, Lahore. Data was collected in the form of demographic characteristics like name, age, gender and those with previous history of treatment, contact, co-morbidities, smoking and socio economic status were noted. The data was entered and analysed by using IBM SPSS.

Results

A total of 41 patients were successfully followed of which 20 (48.8%) were males and 21 (51.2%) were females with male to female ratio of 1:1.05. Mean age of male patients was 35.85±12.60 years and female patients remained 39.8±15.04 years with an overall mean age of 37.87±13.88. A total of 11 (26.8%) patients were re-enrolled 3 (7.3%) had started their treatment from private clinics while same number of patients died after re-enrolment in hospital. High number of 15 (36.6%) patients did not re-enrolled as they were not willing to take further medicine.

Conclusion

Proper counselling and follow up of drug resistant MDR TB defaulters can bring them back to re-enrol for treatment. Most common reason of the patients to default from treatment was parenteral therapy.

Objective

To follow and locate, MDR TB treatment defaulters with an intention to bring them back on treatment.

How to Cite This Article

Iqbal R, Munir MK, Rehman S, Saeed S. Treatment Strategies in Defaulters Among MDR TB Patients. J Pak Soc Intern Med. 2021;2(1):19–23. doi:10.70302/jpsim.v2i1.2106

⭳ Download PDF

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. Zaman K. Tuberculosis: A global health problem. J Health Popul Nutr. 2010; 28(2): 111–13.
  2. World Health Organization. Tuberculosis fact sheet. [Updated 2019, Cited 2021] Available from: [http://www.who.int/mediacentre/factsheets/fs104/en/]
  3. Global tuberculosis report 2020. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
  4. National TB Control Program. Available from website updated January 2014: [www.ntp.gov.pk]
  5. Migliori G B, Loddenkemper R, Blasi F, Ravigilon M C. 125 years after Robert Koch’s discovery of the tubercle bacilli: the new XDR threat. Is “science” enough to tackle the epidemic? Eur Rep J 2007; 294:23-7.
  6. Shringarpure KS, Isaakidis P, Sagili KD, Baxi RK. Loss to follow up in multidrug resistant tuberculosis Treatment in Gujarat, India: The WHEN and WHOof It. PLOS ONE. 2015;10(7): doi:10.1371/journal.pone.0132543 doi:10.1371/journal.pone.0132543
  7. Sanchez-Padilla E, Marquer C, Kalon S, Qayyum S, Hayrapetyan A, Varaine F, Bastard M, Bonnet M. Reasons for defaulting from drug-resistant tuberculosis treatment in Armenia: a quantitative and qualitative study. Int J Tuberc Lung Dis. 2014;18(2):160-7.
  8. Holtz TH, Lancaster J, Laserson KF, Wells CD, Thorpe L, Weyer K. Risk factors associated with default from multidrug-resistant tuberculosis treatment, South Africa, 1999–2001. Int J Tuberc Lung Dis. 2006 ;10(6):649-55.
  9. Rehman S, Munir M K, Iqbal R, Saeed S. Problems faced while treating multidrug resistant TB patients in a tertiary care setting. J Int Academic Res Multidisciplinary. 2018; 6(1): 65-74.
  10. Munir MK, Iqbal R, Shabbir I, Chaudhry K. Factors responsible for failure to initiate tuberculosis treatment among smear positive tuberculosis patients. Pak J Med Res. 2012;51(2):34-7.
  11. Minimum Wages in Pakistan with effect from 01-07-2017 to 30-06-2018. [updated November 2017, Cited April 2018. Available from website: [https://paycheck.pk/main/salary/minimum-wages]
  12. Munir MK, Rehman S, Iqbal R. Meeting the challenge, making a difference: Multidrug resistance tuberculosis in Pakistan. Pak J Med Res. 2018;57(1):1-2.
  13. Muhammad KM, Sana R, Rizwan I. A Need for Tuberculosis Infection Control Measures: A Case Series Study in Pakistan. Asian Journal of Medicine and Biomedicine. 2017;1(1):19-22.
  14. Rehman S, Munir MK, Iqbal R, Salam AA, Saeed S, Masud F, Aasim M. Active case detection among household contacts of multi drug resistant tuberculosis patients in a tertiary care setting. Pak J Med Res. 2014;53(3):55-9.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2021 Journal of Pakistan Society of Internal Medicine.
📃 In This Issue View All
Original Article Impact of Diabetes Mellitus on Post-Operative Wound Healing in General Surgery Siddiqui FA, Noor M, Akhtar W Review Article Statin Therapy in Non-Alcoholic Fatty Liver Disease: A Systematic Review Nawaz F, Cheema HA, Mehmood Y Review Article Thyroid Disorders in Pregnancy: Clinical Implications and Management Strategies Baig BI, Usman A Original Article Serum Ferritin as a Prognostic Marker in COVID-19 Severity: A Hospital-Based Study Rehman N, Sheikh I, Javed K Review Article Antibiotic Resistance Patterns in Community-Acquired Pneumonia: Emerging Trends Hussain I, Farooq Z
👥 More by These Authors
Original Article Outcomes of Laparoscopic Cholecystectomy in Acute Cholecystitis: A Retrospective Analysis Raza SH, Butt N, Qureshi AM Original Article Prevalence of Hypertension Among Urban Adults in Pakistan: A Cross-Sectional Study Khan TM, Ahmed S, Malik RA Original Article Neonatal Sepsis: Bacteriological Profile and Antibiogram in a Tertiary Care Hospital Iqbal M, Rashid T Original Article Comparison of Ultrasound-Guided versus Landmark-Based Central Venous Catheter Insertion Zafar S, Gillani SA
🔗 Related Articles By Keywords
Review Article Thyroid Disorders in Pregnancy: Clinical Implications and Management Strategies Baig BI, Usman A Original Article Serum Ferritin as a Prognostic Marker in COVID-19 Severity: A Hospital-Based Study Rehman N, Sheikh I, Javed K Review Article Antibiotic Resistance Patterns in Community-Acquired Pneumonia: Emerging Trends Hussain I, Farooq Z Original Article Cervical Cancer Screening Awareness Among Rural Women in Punjab Bibi S, Anjum R, Hassan F