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Epidemiol Health > Accepted Articles
Epidemiology and Health 2019;e2019014.
DOI: https://doi.org/10.4178/epih.e2019014    [Accepted] Published online April 20, 2019.
Assessment of the risk factors associated with multidrug resistance tuberculosis in Sudan: a case control study
Adel Hussein Elduma1  , Mohammad Ali Mansournia2  , Abbas Rahimi Foroushani2  , Hamdan Mustafa Hamdan Ali3  , Asrar M. A Salam Elegail4  , Asma Asma Elsony5  , Kourosh Holakouie-Naieni2 
1School of Public Health, Tehran University of Medical Sciences - International Campus, Tehran, Iran
2Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3MDR-Unit, Communicable & Non-communicable Diseases Control Directorate, Federal Ministry of Health, Khartoum, Sudan
4National Tuberculosis Reference Laboratory, National Public Health Laboratory- Ministry of Health, Khartoum, Sudan
5The Epidemiological Laboratory, Khartoum, Sudan
Correspondence  Adel Hussein Elduma ,Tel: +989101543978, Email: dumanet@yahoo.com
Received: April 1, 2019  Accepted after revision: April 20, 2019
Abstract
Objectives:
Emerging of multidrug resistant tuberculosis (MDR-TB) is considered as a major challenge to control TB globally. The aim of this study is to determine the risk factors associated with MDR-TB in Sudan.
Method:
This is a case control study began in May 2017 and finished in February 2019. New MDR-TB was selected as cases, and controls were selected from tuberculosis patients who respond to first line anti-tuberculosis drugs. A designed questionnaire was used to collect data from study participants. Logistic regression was used to evaluate the association between risk factors and infection with MDR-TB. Best multivariable model was selected based on the likelihood ratio test.
Results:
A total number of 430 cases and 860 controls were selected for this study. The adjusted odd ratio (AOR) showed that history of previous TB treatment (AOR = 54.8; 95% CI, 30.48 to 98.69) was strongly association with MDR-TB infection. We identified stop TB treatment (AOR = 7.6; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (AOR =5.4; 95% CI, 2.69 to 10.74), decreased body weight (AOR = 0.8; 95% CI, 0.87 to 0.91), and water pipe smocking (AOR= 3.2; 95% CI, 1.73 to 6.04) were associated with MDR-TB infection.
Conclusion:
History of TB treatment, stop TB treatment, contacts with MDR-TB patient, water pipe smoking were associated with the MDR-TB infection in Sudan. More efforts are required to decrease the rate of default, strengthening patient adherence to treatment, and prevention measures among MDR-TB contact.
Keywords: Risk factors; Tuberculosis, Multidrug resistant; Sudan


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