Sociodemographic and clinical profile of multi drug resistant tuberculosis patients: a study at drug resistant tuberculosis centers of Kolkata

Background:Emergence of drug resistant tuberculosis, particularly multi drug resistant TB (MDR-TB) and extensively drug resistant TB (XDR-TB) has become an obstacle to effective TB control in India. Objectives: To study the sociodemographic and clinical profile of MDR/XDR-TB patients in Kolkata. Methodology: A retrospective study was performed on MDR patients admitted in Jadavpur and Boral TB hospitals, the two designated drug resistant tuberculosis centers (DR-TB center) of Kolkata, in 2013. Results: Out of 172 admitted cases, majority (30.23%) were between 21-30 years. Males were predominant (61.62%). Females were significantly younger compared to males (p=0.002). Most patients (59.9%) were underweight (BMI<18.5kg/m). Among the patients, HIV seropositivity and XDR-TB was found in 2.9% each. According to MDR-TB suspect criteria majority were relapse cases (35.46%). The commonest associated comorbidity was COPD (17.44%). Most patients had bilateral (81.39%) and moderately extensive (38.95%) lesions in chest x-ray. Drug sensitivity testing (DST) showed lowest resistance (1.16%) to pyrazinamide. Conclusion: Relapse of previous antituberculosis treatment was found to be major contributor of MDR-TB suspect cases in Kolkata. Prevalence of resistance to 2 line drugs is still low. Early diagnosis of drug resistance from all re-treatment cases, quality DOTS services and more controlled and rational use of secondline anti-TB drugs can prevent emerging of MDR/XDR-TB as a major public health problem.