MULTIDRUG RESISTANT TUBERCULOSIS AND ITS SOCIAL DETERMINANTS AT NAWABSHAH-SINDH

Abstract

The emergence of multidrug resistant strains of tuberculosis poses an important challenge for the     health care sector in Pakistan. Multidrug resistant tuberculosis strains are resistant to a number of first lines anti tuberculous drugs including at least isonized and rifampicin. The province wise Multi Drug Resistant TB Cases were reported as (51%) the highest number in the Punjab as others provinces, in Sindh (23%), in Khyber Pakhtunkhwa reported as (15%) and lowest (3.5%) in Baluchistan. Main factors contributing to the appearance of drug conflict, which are interval in diagnosis, unsuitable and insufficient drug regimens, practice of poor follow-up, and deficiency of a community provision program. To determine the frequency of multidrug resistant tuberculosis. To find out the Sociodemographic reasons, leading to multiple drug-resistant tuberculosis. This Descriptive cross-sectional study was carried on 230 Diagnosed cases of MDRT tuberculosis, the patients were selected by the purposive sampling method, according to the age, sex, type of patients, nutritional status, socio-economic status, type of method, by which patient was diagnosed, distance from health facility and marital status. A well-designed structured questionnaire was used to gather data and tabulate that data to finally analyze it statistically. The questionnaire was pre-tested before using it for collection of the data. Among 230 subjects (mean age 39.2; 50.4% female), sputum culture analysis revealed a high prevalence of drug resistance (95.2%, n=219). The population was primarily married (73.9%), lower-class (97%), and rural-based, with labor (54%) and housekeeping (20%) as the dominant occupations. Chi-square testing indicated no significant association between resistance and gender, marital status, or other demographic variables, though high resistance rates were observed within crowded occupational settings. Study concluded that there is no significant Association between drug resistance and gender, socioeconomic status and statically significant with Occupation and most of the patients belonging to low socioeconomic status. It observed that Laborers and housewives are at higher risk of TB infection due to occupational and environmental factors. Crowded living and working conditions, silica dust exposure, and poor health literacy contribute to increased susceptibility.

Keywords: Multi drug Resistance-Tuberculosis, Age - Sex - Education level - Income - Occupation.