Prevalence of Multi-Drug Resistant (MDR) pulmonary tuberculosis in a tertiary care hospital of Narshingdi, Bangladesh

Tuberculosis is a chronic, communicable, granulomatous disease. Most infections in humans result in an asymptomatic, latent infection and about one in ten latent infections eventually progresses to active disease, which, if left untreated, kills more than 50% of those infected. In 2011, an anti-tuberculosis (TB) drug resistance survey in Narshingdi, Bangladesh, enrolled new and retreatment patients. In the study, a number of villages were randomly selected and 264 pulmonary tuberculosis (PTB) patients were identified. All the patients received treatment with standardized first-line drug (FLD) regimens and were investigated to document treatment efficiency. Among the patients, 130 were reported in lower income, 117 in medium income and only 17 in higher income group. Farmers (95%) in low income group, and female housewives (68%) in medium income group were mostly infected. Silicosis and malnutrition were assumed responsible for high PTB cases in farmers and housewives respectively. Males were more prone to PTB and the ratios of male to female patients were found to increase with increasing age. The working youth group (25-34) and older people (above 64) were found most vulnerable. Multi-drug resistant (MDR) TB was detected in both new and retreatment patients. Patients with MDR-TB who had been declared cured with first-line anti-TB treatment had a high rate of TB recurrence and death. The rate of TB recurrence and death was high four years after MDR-TB patients were judged to have been cured. PTB patients in Bangladesh had high recurrence and death rates even after treatment with standardized FLD regimens, reinforcing the need for early survey, diagnosis and treatment, including assessment of treatment outcomes.