Clinical risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Mali. (April 2019)

• Record Type: Journal Article
• Authors: Baya, Bocar; Achenbach, Chad J.; Kone, Bourahima; Toloba, Yacouba; Dabitao, Djeneba K.; Diarra, Bassirou; Goita, Drissa; Diabaté, Seydou; Maiga, Mamoudou; Soumare, Dianguina; Ouattara, Khadidia; Kanoute, Tenin; Berthe, Gaoussou; Kamia, Youssouf M.; Sarro, Yeya dit Sadio; Sanogo, Moumine; Togo, Antieme C.G.; Dembele, Bindongo P.P.; Coulibaly, Nadie; Kone, Amadou; Akanbi, Maxwell; Belson, Michael; Dao, Sounkalo; Orsega, Susan; Siddiqui, Sophia; Doumbia, Seydou; Murphy, Robert L.; Diallo, Souleymane
• Is Part Of: International journal of infectious diseases. Volume 81(2019)
• Page Start: 149
• Page End: 155
• Publication Date: 2019-04
• Subjects: Multi-Drug Resistant Tuberculosis -- Risk factors -- Mali; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2019.02.004
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: MDR-TB was associated with younger age in Mali. HIV was not a risk factor for MDR-TB. MDR-TB did alter the patient's physical condition compared to susceptible TB. Tobacco consumption did not increase the risk of developing MDR-TB. Abstract: Background: MDR-TB is a major threat to global TB control. In 2015, 580, 000 were treated for MDR-TB worldwide. The worldwide roll-out of GeneXpert MTB/RIF ® has improved diagnosis of MDR-TB; however, in many countries laboratories are unable to assess drug resistance and clinical predictors of MDR-TB could help target suspected patients. In this study, we aimed to determine the clinical factors associated with MDR-TB in Bamako, Mali. Methods: We performed a cross-sectional study of 214 patients with presumed MDR-TB admitted to University of Bamako Teaching Hospital, Point-G between 2007 and 2016. We calculated crude and adjusted odds ratios for MDR-TB disease diagnosis using SPSS. Results: We found that age ≤40 years (OR = 2.56. 95% CI: 1.44–4.55), two courses of prior TB treatment (OR = 3.25, 95% CI: 1.44–7.30), TB treatment failure (OR = 3.82, 95% CI 1.82–7.79), sputum microscopy with 3+ bacilli load (OR = 1.98, 95% CI: 1.13–3.48) and a history of contact with a TB patient (OR = 2.48, 95% CI: 1.11–5.50) were significantly associated with confirmation of MDR-TB disease. HIV was not a risk factor for MDR-TB (aOR = 0.88, 95% CI: 0.34–1.94). Conclusion: We identified several risk factors that could be used to identify MDR-TB suspects and prioritize them for laboratory confirmation. Prospective studies are needed to understand factors associated with TB incidence and clinical outcomes of TB treatment and disease.