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Title: Drug resistance pattern of Mycobacterium tuberculosis and its association with patients` Knowledge, Attitude and Practice towards tuberculosis in Eastern Amhara Region
Authors: Ahmed, Esmael
Advisors: Mr. Kassue Desta (BSc, MSc
Mr. Ibrahim Ali (BSc, MSc
Mr. Mulualem Agonafir (BSc, MSc)
Keywords: Mycobacterium tuberculosis
Drug resistance
Copyright: Mar-2011
Date Added: 8-May-2012
Publisher: AAU
Abstract: Background: Tuberculosis (TB) remains a serious public health problem, worsened by the emergence and spread of drug resistance particularly multi-drug resistance that threat global TB control. Data obtained from KAP survey is essential to plan, implement and evaluate Advocacy, Communication and Social Mobilization (ACSM) work. Objectives: The aim of this study was to assess the magnitude of drug resistance pattern of M.tuberculosis, knowledge, perception and practice of patients` towards TB in Eastern Amhara Region, North East Ethiopia. Methods: A cross sectional survey was conducted among new and re-treatment patients (age > 18 years old) from September 2010 to February 2011. A structure and pre-validate questionnaires was used to collect data. Primary isolation and DST were carried out on egg based LJ media using indirect proportion method. Chi-Square and multivariate logistic regression was used. Results: Out of 230 study participants for DST, 165 were new cases while 65 were previously treated cases. From these, 66.5% of isolates were sensitive and 4.4% resistance to four first line anti-tuberculosis drugs (HRSE) while the remaining 33.5% was resistance to at least for single drug. MDR-TB was detected in 6.5 % isolates, of which 4.4% were resistance to all four first line drugs. Overall resistance to S, R, H and E was found in 27 % (62), 10 % (23), 17.8 % (41), and 6.5 % (15) respectively. Mono resistance was found in 17.4 % (40) of all isolates Among new cases primary drug resistance for one or more drugs was observed in 23.6 % (39) cases. Primary MDR-TB was found in 3 (1.81%) cases. Similarly among previously treated cases resistance to any drug was found in 58.5 % (38) cases. MDR-TB in previously treated cases was found in 18.46 % (12) Cases; the highest being in failure cases 9.23% (6). More over the mean and median knowledge score of respondents about PTB was 6.81 and 7 respectively. Majority (53.6%) of study subjects had poor knowledge score, feels not well informed about TB and had several misconceptions that need to be clarified. Majority (66.6%) of xv study subjects heard about TB for the first time from health workers. Of study participants, 79.9% mentioned that TB transmits by respiratory droplets through coughing and sneezing and prevents by covering mouth and nose (66.6%). The four common symptoms mentioned by respondents were cough (65.6%), weight loss (33.2%), cough > = 2 weeks (32.7%) and shortness of breath (29.4%). About half of respondent not knew current free cost of TB diagnosis and treatment. Majority of respondents also worried about the disease due to it might transmits to their family, might not be cure, social interact (fear of stigma) and unable to do work. Cost (69.9 %) and difficulties in transportation (54.5 %) mentioned as the main reason for their delaines to seeking care. Previous drug exposure and 1+ bacterial load independently contribute for the development of drug resistance TB strains. Similarly Illiteracy, rural residence, non-previous history of contracting TB, experiencing self treatment option, and delayed frequency of visit were independent predictor of low knowledge score. Conclusion: Drug resistance TB particularly MDR-TB is an emerging problem in new and retreatment patients in our study area. Majority of respondents also had poor knowledge and several misconceptions that need to be clarified. Hence, it is essential to address the problems of drug resistance through establishing good TB control program including DOTS plus service and raise KAPs` of patients through establish proper IEC pathway to indicate the level of severity and to create proper awareness about its cause, transmission, prevention and availability of service.
URI: http://hdl.handle.net/123456789/2827
Appears in:Thesis - Public Health

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