Prevalence and Analysis of Drug Resistance Pattern of MDR-TB in Retreatment Cases at Allied Hospital, Faisalabad, Pakistan

  • Sana Arif House Officer, Allied Hospital, Faisalabad Medical University, Faisalabad, Pakistan
  • Qamar Mehboob Associate Professor, Department of Physiology, Faisalabad Medical University, Faisalabad
  • Waqar Arif Post Graduate Resident Plastic Surgery department, Allied Burn & Reconstructive Surgery Center Faisalabad Medical University, Faisalabad, Pakistan
Keywords: Multi drug resistance, Retreatment cases,, Tuberculosis


Background: The prevalence of Multi-Drug Resistance-Tuberculosis (MDR-TB) among retreatment cases is very high. It has become a serious public health issue in Pakistan and can affect greatly TB control strategies. So, we conducted the present research work to update a systematic review of the literature available on MDR-TB cases. Objective: To analyze the resistance pattern of multidrug-resistant tuberculosis. To study the prevalence of MDR-TB among new cases, retreatment cases. Study Design: Cross-sectional study. Settings: Pathology department, Allied Hospital, Faisalabad Medical University, Faisalabad, Pakistan. Duration: Six months from January 01, 2020 to June 30, 2020. Methodology: In this study, we included new and retreatment tuberculosis cases. Gene mutation RpoB, DNA band sequence detected by using machine, Cepheid gene Xpert IV – 4 Modules, Sr # 806133. Data was collected and analyzed statistically by using SPSS v 20. Results: 858 cases were included of age 12 years – 100yrs with the mean age (in years) 42.139 ± 16.823.  Two groups of males and females were studied separately. Group I included male patients {456 (56.64%)} and further subdivided into IA [age above 30 years, {354(72.84%)}] and IB [age below 30 years {132 (27.15%)}]. Group II included female patients {372 (43.36%)} and further subdivided into IIA [age above 30 years {239 (64.25%)}] and IIB [age below 30 years {133(35.75%)}]. Out of 858 cases, 347 (40.44%) were New cases, 13 (1.51%) New cases with HIV and 408 (47.55%) were Previously Treated patients (PT). 30 (3.45%) cases were unknown (UK). 28 (3.26%) cases were brought by different lady health workers (LHW) and relapse cases were 32 (3.73%). Overall statistical analysis was found to be highly significant (p=0.000, df= 1, CI= 95%). According to our results, in 517 (60.26%) patients, Mycobacterium Tuberculosis was not detected (MTB-ND). In 214 (24.94%) cases, Mycobacterium Tuberculosis was detected (MTB-D), out of which 13 (6.07%) cases were of First-Line Multi Drug Resistance (MDR). Age of MDR cases was in between 17- 70 years with the mean age (in years) 37.307 ± 17.637. Our results showed MDR more in males (53. 85%) as compared to female patients (46. 15%). Our results showed a significant correlation between status of all cases and their reports (p= -.050). For MTB-ND cases p= 0.000, df =1, CI=95% and for invalid cases p= 0.000, df =5, CI=95%. Conclusion: There is a great need to implement national tuberculosis guidelines fully.  In order to prevent further emergence of drug resistance, we should focus on effective implementation of directly observed therapy short courses.