Meta-Analysis: Risk Factors Associated with Multidrugs-Resistant Tuberculosis (MDR-TB) in Tuberculosis Patients
Abstract
Background: Today, the world not only has to face a higher number of deaths from TB every year, but other challenges arise in the form of drug-resistant TB with risk factors that can affect the incidence of MDR TB, namely treatment-related factors (direct) and other factors (not direct). direct) such as biological, social, economic, and health system factors. The aim of this study was to estimate the risk of HIV infection, smoking and previous medication history on the incidence of MDR TB, with a meta-analysis of primary studies conducted by previous authors.
Subjects and Method: This study was conducted using a systematic review and meta-analysis study design using PICO, population: Tuberculosis Patients. Intervention: Risk Factors for HIV Infection, Smoking, and History of Medication. Comparison: no HIV infection, no smoking and no history of medication, Outcome: MDR-TB incidence. The articles used in this study came from 4 databases, namely Pubmed, ScienceDirect, ProQuest and Google scholar. The article keywords are ("Risk factor" or "associated") AND ("Multidrug resistant Tuberculosis" or "MDR TB") AND “Case Control” AND (HIV or Smoke or treatment). The articles included in this study are full paper articles, case-control study designs, 2011-2021 and the size of the relationship between Adj Odds Ratio. Article selection is done using PRISMA. Articles were analyzed using the Review Manager 5.3 application.
Results: A total of 20 case-control studies with 18,790 TB patients with details of 4,220 cases and 14,570 controls from 3 America, Africa, and Asia. HIV infection had a risk of 2.05 times in TB patients becoming MDR-TB (aOR = 2.05; 95% CI = 1.03 to 4.07; p= 0.040). Smoking had a 2.2 times risk in TB patients for MDR-TB (aOR= 2.20; 95% CI= 1.87 to 2.59; p<0.001). History of TB treatment had a 9.08 times risk in TB patients to become MDR-TB (aOR=9.08; 95% CI= 5.49 to 15.03; p<0.001).
Conclusion: Risk factors for HIV infection, smoking and history of TB treatment increase the incidence of TB to MDR-TB.
Keywords: Multidrugs Resistant Tuberculosis, HIV, smoking, TB treatment history
Correspondence:
Nurul Dwi Andriani. Public Health Science, Faculty of Public Health, Universitas Diponegoro, Central Java, Indonesia. Jl. Prof. Sudarto No.13, Tembalang, Semarang, Central Java. Email: nurul.d.andriani@gmail.com. Mobile: +6282137279586
Journal of Health Promotion and Behavior (2021), 06(03): 233-249
DOI: https://doi.org/10.26911/thejhpb.2021.06.03.07
References
Ahmad AM, Akhtar S, Hasan R, Khan JA, Hussain SF, Rizvi N (2012). Risk Fac-tors for Multidrug-resistant Tubercu-losis in Urban Pakistan : A Multi¬center case-control study.Int J Myco-bacteriol, 1(3): 137-142. DOI: 10.¬1016-/J.IJMYCO.2012.07.007.
Alene KA, Viney K, McBryde ES, Gray DJ, Melku M (2019). Risk factors for multi¬drug-resistant tuberculosis in northwest Ethiopia: A case–control study. Transbound Emerg Dis, 66(4): 1611–1618. DOI: 10.1111/tbed.13188.
Ali MH, Alrasheedy AA, Hassali MA, Kibuule D, Godman B (2019). Predictors of Multidrug-Resistant Tuberculosis (MDR-TB) in Sudan. Antibiotics, 8(90): 1–11. DOI: 10.3390/antibio-tics8030090
Ambaye GY and Tsegaye GW (2021). Fac-tors Associated with Multi-Drug Resistant Tuberculosis among TB Patients in Selected Treatment Centers of Amhara Region: A Case-Control Study. Ethiop J Health Sci. 31(1): 25-34. DOI: 10.4314/ejhs.v31i1.4.
Amin Z, Mitiku H, Marami D, Shume T, Weldegebreal F (2021). Magnitude of multidrug resistance and associated factors of pulmonary tuberculosis among adult smear positive patients in eastern ethiopia. Infect Drug Resist, 14: 4493–4500. DOI: 10.2147/IDR.-S326798.
Chen S, Huai P, Wang X, Zhong J, Wang X, Wang K, et al. (2013). Risk factors for multidrug resistance among previously treated patients with tuberculosis in eastern China: a case-control study. International journal of infectious dise-ases. J Glob Infect Dis. 17(12): e1116–e1120. DOI: https://doi.org/10.1016/j.ijid.2013.06.006.
Elduma AH, Mansournia MA, Foroushani AR, Ali HMH, Elegail AMA/S, Elsony A, Holakouie-Naieni K (2019). Assessment of the risk factors associated with multidrug resistant tuberculosis in Sudan: a case-control study. Epidemiol Infect. 41: 1–9. DOI: 10.4178/epih.e2019014.
Elmi OS, Hasan H, Abdullah S, Jeab MZM, Alwi ZB, Naing NN (2015). Multidrug-resistant tuberculosis and risk factors associated with its development: A retrospective study. JIDC, 9(10): 1076–1085. DOI: 10.3855/jidc.6162.
Garrido MS et al. (2012). Factors associated with tuberculosis treatment default in an endemic area of the Brazilian Amazon: A case control-study. PLoS ONE, 7(6): 1–7. DOI: 10.1371/journal.pone.0039134.
Godavitarne C, Robertson A, Ricketts DM, Rogers BA (2018). Understanding and interpreting funnel plots for the clinician. Br J Hosp Med. 79(10): 578–583. DOI: 10.12968/hmed.2018.79.10.578.
Hirpa S, Medhin G, Girma B, Melese M, Mekonen A, Suarez P, Ameni G (2013). Determinants of multidrug resistant tuberculosis in patients who underwent first line treatment in Addis Ababa: a case control study. BMC Public Health, 13(782). DOI :10.1186/1471-2458-13-782
Huai P, Huang X, Cheng J, Zhang C, Wang K, Wang X, Yang L et al. (2016). Proportions and Risk Factors of Developing Multidrug Resistance Among Patients with Tuberculosis in China: A Population-Based Case-Control Study. Microbial drug resistance (Larchmont,N.Y.), 22(8), 717–726. https://doi.org/10.1089/mdr.2015.0186
Iradukunda A, Ndayishimiye GP, Sinarinzi D, Odjidja EN, Ntakaburimvo N, Nshimirimana I (2021). Key factors influencing multidrug resistant tuberculosis in patients under anti tuberculosis treatment in two centres in Bu-rundi: a mixed effect modelling study. BMC Public Health, 21: 1-9. DOI: 10.1186/s12889-021-12233-2.
Jitmuang A, Munjit P, Foongladda S (2015). Prevalence and Factors Associated With Multidrug-Resistant Tuberculosis At Siriraj Hospital, Bangkok, Thailand. Southeast Asian J Trop Med Public Health, 46(4): 697–706. DOI : 26867390
Mesfin EA,Beyene D,Tesfaye A, Admasu A, Addise D, Amare M, Dagne B (2018). Drug resistance patterns of mycobacterium tuberculosis strains and associated risk factors among multi drug resistant tuberculosis suspected patients from Ethiopia. PLoS ONE, 13(6). DOI: 10.1371/Journal.Pone.¬01¬9-7737.
Mollel EW, Chilongola JO (2017). Predictors for Mortality among Multidrug Resistant Tuberculosis Patients in Tanzania. J Trop Med. DOI: 10.1155/2017/9241238.
Mulisa G, Workneh T, Hordofa N, Suaudi M, Abebe G, Jarso G (2015). Multidrug resistant Mycobacterium tuberculosis and associated risk factors in Oromia Region of Ethiopia. J Glob Infect Dis. 39: 57–61. DOI: 10.1016/j.ijid.2015.08.013.
Rifat M, Milton AH, Hall J, Oldmeadow C, Islam MA, Husain A, Akhanda MW, et al. (2014). Development of multidrug resistant tuberculosis in Bangladesh: A case-control study on risk factors. PLoS ONE, 9(8): 1–7. DOI: 10.1371/journal.pone.0105214.
Ndiaye M, Yanogo PK, Sawadogo B, Diallo F, Antara S, Meda N (2019). Factors associated with multidrug resistant tuberculosis in Dakar, Senegal, 2010-2016. J Public Health Afr. 10(2): 80–83. DOI: 10.4081/jphia.2019.1099.
Shariff MN, Shah SA and Kamaludin F (2016). Previous treatment, sputum smear nonconversion, and suburban living: The risk factors of multidrug resistant tuberculosis among Malaysians. Microbiol. 5(1): 51–58. DOI: 10.1016/j.ijmyco.2015.11.001.
Sharma P, Lalwani J, Pandey P, Thakur A (2019). Factors associated with the development of secondary multidrug-resistant tuberculosis. Int J Prev Med. 10(67): 1–7. DOI: 10.4103/ijpvm.IJP-VM_298_17. eCollection 2019.
Shivekar SS, Kaliaperumal V, Bramma-charry U, Sakkaravarthy A, Raj CKV, Alagappan C, Muthaiah M (2020). Prevalence and factors associated with multidrug-resistant tuberculosis in South India. Nature, 10(17552): 1–11. DOI: 10.1038/s41598-020-74432-y.
Singh A, Prasad R, Balasubramanian V, Gupta N (2020). Drug Resistant Tuberculosis and HIV Infection: Current Perspectives. Dovepress, 12: 9–31. DOI: 10.2147/HIV.S193059.
Tenzin C, Chansatitporn N, Dendup T, Dor¬ji T, Lhazeen K, Tshering D, Pelzang T. (2020). Factors associated with multidrug resistant tuberculosis in Bhutan: A nationwide case-control study. PLoS ONE, 15(7): 1–13. DOI: 10.1371/journal.pone.0236250.
WHO (2020). WHO consolidated guide¬lines on tuberculosis. Module 4: treatment drug resistant tuberculosis treatment. Online annexes. WHO. Geneva.
Workicho A, Kassahun W and Alemseged F. (2017). Risk factors for multidrug resistant tuberculosis among tuberculosis patients: a case-control study. Infect Drug Resist, 10: 91–96. DOI: 10.1186/s12889-018-6021-5.
World Health Organization (2021) Tuber-culosis Report 2021. Geneva: World Health Organization.
Zhang C, Wang Y, Shi G, Han W, Zhao H, Zhang H, Xi X. (2016). Determinants of multidrug resistant tuberculosis in Henan province in China: a case control study. BMC Public Health, 16(42): 1–8. DOI: 10.1186/S12889-016-2711-Z.
