Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study / 한국역학회지

OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan. METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test. RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection. CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients’ adherence to treatment, and to reduce contact with MDR-TB patients.

Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study / 한국역학회지

OBJECTIVES@#The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.@*METHODS@#This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.@*RESULTS@#A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.@*CONCLUSIONS@#Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients' adherence to treatment, and to reduce contact with MDR-TB patients.

Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study / 한국역학회지

OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients' adherence to treatment, and to reduce contact with MDR-TB patients.

Validation of the score for allergic rhinitis [SFAR] in Sudan

This study aimed to validate the Score for Allergic Rhinitis [SFAR] in clinically diagnosed Allergic Rhinitis patients in Sudan and to identify the most common allegens and other factors causing hypersensitivity. A cross-sectional study was carried out in the departments of Physiology, National Ribat University [Khartoum city] and Ahfad University for Women [Omdurman city], Sudan. Seventy three patients, 18-65 years of age, both sexes [40 females and 33 males], suffering from either Allergic Rhinitis referred by ENT Hospitals Units, or Asthma referred by Ribat hospital chest until or both and forty control [26 females and 14 males] without any nasal pathology were included in the study. The score for allergic rhinitis [SFAR] questionnaire was validated using skin prick test for common allergens. Ninety seven percent of both AR asthmatics and non-asthmatics have a score for AR >/= 7 compared to none of the control. 55.6% of AR patients and 61.8% of AR Asthmatic patients have positive skin tests [for at least one allergen], giving a sensitivity and specificity of 60.3% and 90% respectively for the SFAR. We have also found that the positive skin prick tests for at least one allergen were higher within AR asthmatic patients than within AR non asthmatics and Control, 61.9%, 55.6% and 10% respectively. The result showed that the Score for Allergic Rhinitis can be used with 60.3% confidence to diagnose AR in Sudan. The most common allergens causing hypersensitivity are D.Pteronyssinus, D. farine, Cats, Cockroaches and Betulace family trees

Community and individual factors influencing the health seeking behavior of tuberculosis defaulters, Sudan

This study was carried out in Sudan, in three areas; Abu Anga Hospital, which represented urban areas, Al Gadarif State, stood for rural areas and Mayo Farm represented displaced population, in the period from June-December 2002. The objective is to determine the health seeking behavior of tuberculosis defaulters, and to assess patients' knowledge about tuberculosis, treatment, and mode of spread. Prospective cohort study of 409 new tuberculosis cases, visiting the outpatient chest clinics in the general health services in the three selected areas during March to May 2001, patients were followed up after their registration for six months. Out of the 409 tuberculosis patients included in the study, 107 [26.2%] were defaulters; 36 [33.6%] from Abu Anja hospital, 33 [30.8%] from Al Gedarif State and 38 [35.5%] from Mayo Farm clinic. The majority of defaulters were males [64.5%] compared to 35.5% females. Analysis of results reflected that 64% of defaulters compared to 60% of non-defaulters thought that TB is not infectious. Others had misconception about adverse reactions duration of treatment and other wrong information regarding the management of tuberculosis, which was 31.8% among defaulters to compare to 21.3% among non defaulters. Defaulters came to consultation in severe conditions, and usually did not inform their families about their illness. They tended to seek health care with more period of delay compared to non-defaulters. The main cause of delay in seeking the treatment and defaulting was financial problems, this insists on the role of the ministry of finance to alleviate poverty. The knowledge of both defaulters and non-defaulters about the disease was not sufficient, strengthening of health education activities by the National Tuberculosis program is essential