Trends of Drug Resistant Tuberculosis at Oshakati Namibia 2012-2016

  • Anti-microbial resistance
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Background:
Drug Resistant Tuberculosis (DR-TB) poses serious challenges for tuberculosis control. Worldwide, about 3% of all newly diagnosed patients have DR-TB. Namibia reported an increase in the notification of TB cases from 9,882 in 2014 to 9,944 in 2015, making the country one of the worst affected by TB in the world. Oshana region reported 527 TB cases in 2015 of which 42 were DR-TB. This study aimed at determining the trends of drug resistance tuberculosis and its associated factors.
Methods:
A retrospective review of records was conducted. We reviewed data recorded from 2012 to 2016. Epi info 7 was used for data analysis and to determine the frequencies and proportions of the types of drug resistance and risk factors. Chi-square test for trends was performed at p-value < 0.05.
Results:
Total of 194 DR-TB cases were identified from the records. Of these, 115 (59.28%) were male. The mean age was 37 (SD= 13.36). There were 180 (92.78%) Multidrug resistance, 7 (3.61%) Poly resistance, 6 (3.09%) Mono resistance and 1 (0.52%) Extensive drug resistance. Out of 194 DR-TB, 87 (44.85%) were cured and 20 (10.32%) defaulted. There were 103 (66.88%) patients from rural areas, 38 (24.68%) from Urban and 13 (8.44%) foreign nationals. The prevalence of DR-TB over the period was 194/588 (32.99%) and there was a general increase in DR-TB prevalence: 2012 was 32/873 (16.49 %) and increase to 40/619 (20.62 %) in 2013 and 46/581 (23.71%) in 2014 with slight decrease to 42/527 (21.65%) in 2015 and 34/588 (17.53%) in 2016 (p-value = 0.004).
Conclusion
DR-TB still remains a public health concern as new cases are being recorded. We recommended the Oshana Regional Health Directorate to conduct intensive health education on treatment adherence among Tuberculosis patients with regular follow-up and further analytical study to identify major determinants. We also recommended active case search in the community for early detection and curb the spread of the disease. Clinician sensitization on treatment adherence was also encouraged.

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