Factors Associated with drug-resistant tuberculosis (DR-TB) in Health Region 6
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Abstract
The World Health Organization estimates that Thailand has an incidence of multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) of approximately 4 cases per 100,000 population per year. Health Region 6 has reported an increasing number of drug-resistant tuberculosis cases. This study was a case-control study using secondary data from tuberculosis patients registered for treatment in the National Tuberculosis Information Program (NTIP) in Health Region 6 between October 1, 2021 and September 30, 2024. A total of 1,131 patients were included, with a 1:2 ratio between drug-resistant and drug-susceptible tuberculosis patients, selected using systematic random sampling. The data consisted of three domains: personal factors, health-related factors, and tuberculosis treatment–related factors. Data were analyzed using descriptive statistics and multiple logistic regression. The results showed that most tuberculosis patients were male (68.2%), with the highest proportion observed among individuals aged 35–44 years (21.0%), of Thai nationality (94.0%), and unemployed (50.4%). Factors significantly associated with drug-resistant tuberculosis (p-value < 0.05) included pulmonary tuberculosis (aOR = 12.23; 95% CI = 1.97-22.50), relapse tuberculosis (aOR = 8.31; 95% CI = 3.37-20.52), positive AFB smear at diagnosis (aOR = 2.89; 95% CI = 1.83-4.60), HIV infection (aOR = 2.45; 95% CI = 1.22-4.92), diabetes mellitus (aOR = 1.30; 95% CI = 1.12-4.71), and duration of tuberculosis treatment (< 6 months: aOR = 2.07; 95% CI = 1.96-4.46; > 9 months: aOR = 1.11; 95% CI = 1.05-1.21). It is recommended to promote the development of a “One Stop TB Risk Management” policy covering patients with HIV, diabetes mellitus, recurrent tuberculosis, and smear-positive pulmonary tuberculosis. This approach should emphasize intensive screening of high-risk groups, establish drug susceptibility testing as a standing order for all tuberculosis patients, and develop a surveillance system for risk factors.
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ผู้แต่งที่ตีพิมพ์กับวารสารโรคและภัยสุขภาพ ภาคตะวันออก ประเทศไทย จะต้องยอมรับเงื่อนไขต่อไปนี้ :
ผู้แต่งจะต้องสงวนลิขสิทธิ์และให้สิทธิ์กับวารสารในการตีพิมพ์เผยแพร่บทความ โดยบทความจะถือเป็นลิขสิทธ์ของ สำนักงานป้องกันควบคุมโรคที่ 6 จังหวัดชลบุรี
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