A COMPARATIVE STUDY ON PREDISPOSING FACTORS FOR THE DEVELOPMENT OF DRUG SUSCEPTIBLE AND DRUG RESISTANT CASES IN PULMONARY TB RETREATMENT CASES AT GOVERNMENT CHEST DISEASES AND TB HOSPITAL, HANUMAKONDA
DOI:
https://doi.org/10.69980/y5y6f269Keywords:
Pulmonary Tuberculosis, Retreatment Tuberculosis Cases, Tuberculosis Risk Factors, Treatment Default, Smoking and Tuberculosis, Tuberculosis RecurrenceAbstract
Background: Drug-resistant tuberculosis (DR-TB) remains a major challenge to tuberculosis control programmes, particularly among retreatment pulmonary TB cases. Identifying factors associated with the development of drug resistance is essential for improving treatment outcomes and preventing transmission. Materials and Methods: This analytical observational cross-sectional study was conducted over 24 months (May 2023–April 2025) at Government Chest Diseases and Tuberculosis Hospital, Hanumakonda. A total of 100 pulmonary TB retreatment cases aged ≥18 years were included, comprising 50 drug-resistant (DR-TB) and 50 drug-sensitive (DS-TB) cases. Demographic, clinical, microbiological, radiological, and treatment-related factors were assessed. Data were analyzed using SPSS software, and associations were evaluated using the Chi-square test, with p<0.05 considered statistically significant. Results: Significant factors associated with DR-TB included older age (p=0.037), male gender (88% vs. 68%, p=0.0158), illiteracy (26% vs. 10%, p=0.0373), alcohol consumption (84% vs. 62%, p=0.013), smoking (p=0.0001), multiple previous TB episodes (26% vs. 10%, p=0.037), longer interval between TB episodes (p=0.0004), previous loss to follow-up (64% vs. 42%, p=0.027), and default during the intensive phase of prior treatment (p=0.007). Undernutrition and anaemia were highly prevalent and significantly associated with disease status. HIV, diabetes mellitus, hypoproteinemia, sputum smear positivity, and radiological severity did not show significant association with drug resistance. Conclusion: Male gender, poor education, smoking, alcohol use, multiple TB episodes, and treatment default were important predictors of DR-TB. Strengthening counselling, adherence monitoring, nutritional rehabilitation, and tobacco/alcohol cessation interventions may help reduce the burden of drug-resistant tuberculosis.
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