Determinants of Multidrug-Resistant Tuberculosis among Retreatment Tuberculosis Patients in South Sulawesi Province: A Case-Control Study

Abstract

Multidrug-resistant tuberculosis (MDR-TB) is an increasing global concern including in Indonesia. The estimated cases of multidrug-resistant tuberculosis in this country were 6,900 cases in which new MDR-TB cases were 1.9% and recurrent MDR-TB cases were 12%. For such a reason, the aim of this study was to identify the determinants of MDR-TB incidence in retreatment tuberculosis patients at the Labuang Baji General Hospital in Makassar Municipality. The research design in this study was a case-control study which located at the Labuang Baji General Hospital as the referral hospital for multidrug-resistant tuberculosis cases. A total number of samples in this study were 160 cases with a 1:1 ratio. Case was MDR TB patients who was confirmed RMP resistant using geneXpert test, and it was then confirmed from culture test and drug sensitivity test (DST) of resistant to both RMP and INH . Control was presumptive MDR TB patient that result of geneXpert test was RMP sensitive. Data were collected by structured interview questionnaire. Multivariate logistic regression analysis was computed to determine the risk factors associated with MDR TB. Results of this study indicated that low level of education (AOR=0.59; 95% CI: 0.38-0.94), low income (AOR=3.97; 95% CI: 1.65-9.51) and health facilities for the non-DOTS group (AOR=3.45; 95% CI: 1.42-8.37) were the risk factors of MDR TB in retreatment tuberculosis patients.

Conclusion of study is determinants of MDR TB in retreatment tuberculosis patients analyzed in this study significantly indicated high risk level of MDR TB. Consequently, there should be a strengthening effort in formulating and implementing directly observed therapy (DOTS) policy plans at health facilities to improve medication compliance among patiens in achieving exhaustively tuberculosis treatment and focusing medical treatment by giving priority to the accessibility of geneXpert test, culture test dan drug sensitivity test (DST) at laboratory facilities.