Role of Risk Factors in the Incidence of Multidrug-Resistant Tuberculosis

Alya Putri Khairani, Prayudi Santoso, Elsa Pudji Setiawati


Objective: To determine the risk factors that played roles in the incidence of multidrug-resistant tuberculosis (MDR-TB) in such patients. Multidrug-Resistant Tuberculosis is a form of tuberculosis caused by Mycobacterium tuberculosis that is resistant to at least isoniazid and rifampicin.

Methods: This was a case control study to compare MDR-TB to non-MDR-TB pulmonary tuberculosis outpatients in Dr. Hasan Sadikin General Hospital, Bandung on August–September 2014. Fifty MDR-TB outpatients were included as the cases and 50 non-MDR-TB outpatients as controls. Data was collected by questionnaires and patient’s registration forms. Bivariate and multivariate analyses were performed using chi-square test and multiple logistic regression test, with p<0.05 considered significant.

Results: From bivariate analysis, number of previous tuberculosis treatments, regularity of previous treatment, and burden of cost were significant risk factors for developing MDR-TB (p<0.05); while from multivariate analysis, number of previous TB treatments was the only risk factor that played a significant role in the incidence of MDR-TB (OR 24.128 95% CI 6.771-85,976).

Conclusions: Patients and medication factors are risk factors that play roles in the incidence of MDR-TB. The significant risk factor is the number of previous TB treatment.

Keywords: Multidrug-resistant tuberculosis, resistance, risk factors, tuberculosis


DOI: 10.15850/ijihs.v5n2.991


Multidrug-resistant tuberculosis, resistance, tuberculosis, risk factors

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WHO. Global Tuberculosis Report 2016. Geneva, Switzerland: WHO; 2016.

Nathanson E, Nunn P, Uplekar M, Floyd K, Jaramillo E, Lönnroth K, et al. MDR tuberculosis—critical steps for prevention and control. N Eng J Med. 2010;363(11):1050–8.

Gandhi NR, Nunn P, Dheda K, Schaaf HS, Zignol M, Soolingen DV, et al. Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis. Lancet. 2010;375(9728):1830–43.

Chiang CY, Centis R, Migliori GB. Drug-resistant tuberculosis: past, present, future. Respirology. 2010;15(3):413–32.

Fauci AS. Multidrug-resistant and extensively drug-resistant tuberculosis: the national institute of allergy and infectious diseases research agenda and recommendations for priority research. J Infect Dis. 2008;197(11):1493–8.

Nofizar D, Nawas A, Burhan E. Identification of risk factors in multidrug resistant tuberculosis. MJI. 2011;60(12):537–45.

Zhao Y, Xu S, Wang L, Chin DP, Wang S, Jiang G, et al. National survey of drug-resistant tuberculosis in China. N Engl J Med. 2012;366(23):2161–70.

Law WS, Yew WW, Chiu Leung C, Kam KM, Tam CM, Chan CK, et al. Risk factors for multidrug-resistant tuberculosis in Hong Kong. Int J Tuberc Lung Dis. 2008;12(9):1065–70.

Sarwani D, Nurlaela S, Isnani ZA. Analisis faktor risiko multidrug resistant tuberculosis (MDR-TB) (Studi Kasus di BP4 Purwokerto). JKM. 2013;8(1):62–8.

Caminero JA. Multidrug-resistant tuberculosis: epidemiology, risk factors and case finding [State of the art series. Drug-resistant tuberculosis. Int J Tuberc Lung Dis. 2010;14(4):382–90.

WHO. Multidrug-resistant tuberculosis in Belarus: the size of the problem and associated risk factors. Bull WHO. 2013;91(1):36–45.

Temple B, Ayakaka I, Ogwang S, Nabanjja H, Kayes S, Nakubulwa S, et al. Rate and amplification of drug resistance among previously-treated patients with tuberculosis in Kampala, Uganda. Clin Infect Dis. 2008;47(9):1126–34.

Barroso EC, Mota RMS, Santos RO, Sousa ALO, Barroso JB, Rodrigues JLN. Risk factors for acquired multidrug-resistant tuberculosis. J Pneumologia. 2003;29(2):89–97.

Jaggarajamma K, Sudha G, Chandrasekaran V, Nirupa C, Thomas A, Santha T, et al. Reasons for non-compliance among patients treated under Revised National Tuberculosis Control Programme (RNTCP), Tiruvallur district, South India. Indian J Tuberc. 2007;54(3):130–5.

Lomtadze N, Aspindzelashvili R, Janjgava M, Mirtskhulava V, Wright A, Blumberg HM, et al. Prevalence and risk factors for multidrug-resistant tuberculosis in the Republic of Georgia: a population-based study. Int J Tuberc Lung Dis. 2009;13(1):68–73.

Hill PC, Stevens W, Hill S, Bah J, Donkor SA, Jallow A, et al. Risk factors for defaulting from tuberculosis treatment: a prospective cohort study of 301 cases in the Gambia. Int J Tuberc Lung Dis. 2005;9(12):1349–54.

Wahab F, Ashraf S, Khan N, Anwar R, Afridi MZ. Risk factors for multi-drug resistant tuberculosis in patients at tertiary care hospital, Peshawar. J College Physicians Surg Pakist. 2009;19(3):162–4.

García Vázquez E, Esteban J, De Gorgolas M, Fernández Guerrero ML. Infection by resistant Mycobacterium tuberculosis in a hospital population. A longitudinal study of incidental cases at the Fundacion Jimenez Diaz. Revista Clinica Espanola. 1999;199(9):564–8.

Otero L, Krapp F, Tomatis C, Zamudio C, Matthys F, Gotuzzo E, et al. High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors. PLOS ONE [serial on the internet]. 2011 Oct [cited 2014 Aug 12];6(10):[about 7p.]. Available from:

Turbawaty DK, Gustiani N, Noviani L, Parwati I. Validity of Mycobacterium tuberculosis Antigens Cocktail: ESAT-6, CFP-10 and MPT64 in Sputum and Cerebrospinal Fluid for Pulmonary Tuberculosis and Tuberculous Meningitis Diagnosis. IJIHS. 2015;3(2):60–5.


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