Prevalence and drug resistance pattern of MDR TB in retreatment cases of Punjab,Pakistan

Objective: to determine the prevalence and resistance pattern of multidrug-resistant tuberculosis. methods: this cross-sectional study was carried out from january 2010 to june 2014 in nine tertiary care hospitals implementing programmatic management of drug-resistant tuberculosis in punjab,and comprised retreatment tuberculosis cases. data was collected from the electronic nominal review system. spss 17 was used for data analysis. results: of the 1,250 cases,861(69%) were of multidrug-resistant tuberculosis confirmed through drug sensitivity testing. the mean age was 32 (±13.5 sd) years. besides,664(53%) were males and 1,208(97%) resided in urban areas of punjab. multidrug-resistant tuberculosis was found to be more prevalent in the most productive age group,i.e. 15-45 years,with 709(57%) cases (p<0.05),in urban areas1,208(97%) cases (p<0.05) and in the pulmonary site 852(68%) cases (p<0.05). overall,391(41%) cases showed resistance to all first-line anti-tuberculosis drugs while 239(28%) showed resistance to oral first-line drugs. besides,526(42%) cases showed resistance to fluoroquinolones and 650(52%) to second-line drugs. of them,420(81%),(p<0.05) patients showed highly significant resistance to fluoroquinolones and 26(5%) to ethionamide. conclusion: there is a need to fully implement national tuberculosis guidelines with a focus on expansion and effective implementation of directly observed therapy short course in order to prevent further emergence of drug resistance. © 2016,pakistan medical association. all rights reserved.