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A Meta-Analysis on the Risk Factors Associated with Multidrug-resistant Tuberculosis (MDR-TB) in Southeast Asia.

The emergence of multidrug resistant tuberculosis (MDR-TB) poses a new challenge in the existing problem of tuberculosis in developing countries such as the Philippines. Culture sensitivity testing for Mycobacterium tuberculosis (MTB CS), and GeneXpert MTB/RIF assay, which are the gold standards for the detection of MDR-TB, are expensive methods that entail a high out-of-pocket (OOP) expenditure. Hence, this study aims to determine the risk factors associated with the development of MDR-TB in Southeast Asia to establish a determinant and an additional basis for the assessment of the need of culture sensitivity testing in patients with pulmonary tuberculosis. A systematic review and meta-analysis of eleven studies on the risk factors for MDR-TB in Southeast Asia gathered from different journal databases was conducted. The selection of risk factors to be tested were those that were common in at least two studies. A total of fourteen factors were chosen, and eight out of these fourteen factors, namely treatment non-compliance (OR=6.20 95% CI: 2.75, 13.98), previous history of TB treatment (OR=4.25, 95% CI 2.97-6.08), cavity in chest X-ray (OR = 4.65, 95% CI 3.07-7.05), AFB smear (OR= 1.90, 95% CI: 1.24, 2.91), HIV status (OR=1.89, 95% CI: 1.24, 2.89), age belonging to the younger age group (OR = 2.06, 95% CI: 1.37-3.09), marital status belonging to the single subgroup (OR = 0.41, 95% CI: 0.21, 0.81), and alcohol consumption (OR= 1.80, 95% CI: 1.13, 2.86), were significantly associated with the development of MDR-TB. The presence of risk factors to develop MDR-TB will make laboratory work-ups, specifically MTB CS and GeneXpert MTB/RIF assay, more reasonable for economically challenged countries.

(*) Tady, Kristine Claire Dulla (1,4), (*) Tabuno, Angelette Flores (1,4), (*) Tanghal, Juan Alfonso Ortiz (1,4), (*) Cadiz, Renarose Angela Jonson (1,4), Olives, Trysh Danielle (2,4), Capinpin, Bernard Kean Mappala (3,4)

(1) University of Santo Tomas, Faculty of Medicine and Surgery, (2) University of the East Ramon Magsaysay Memorial Medical Center, (3) St. Luke's College of Medicine, (4) Asian Medical Students Association - Philippines, (*) contributed equally to this paper

Adviser: Daisy Ilagan-Tagarda, MD

Submitted to the Asian Medical Student' Conference 2018 Malaysia

"Infection Control: Old Problems and New Challenges"

July 8- 15, 2018

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Author:Tady, Kristine Claire Dulla; Tabuno, Angelette Flores; Tanghal, Juan Alfonso Ortiz; Cadiz, Renarose
Publication:Journal of Asian Medical Student Association
Article Type:Report
Geographic Code:90SOU
Date:Aug 1, 2018
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