Prevalence and factors associated with multidrug/rifampicin resistant tuberculosis among suspected drug resistant tuberculosis patients in Botswana

Abstract

Background: To investigate the prevalence and factors associated with the prevalence of multidrug/rifampicin-resistant tuberculosis among suspected drug resistant tuberculosis patients in Botswana. Methods: A retrospective review of medical records of suspected drug resistant tuberculosis patients receiving care at public health facilities in Botswana was conducted from January, 2013 and December, 2014. Patient characteristics and drug susceptibility data were abstracted from 2568 medical records on to a pre-tested checklist form. The prevalence of multidrug/rifampicin resistance was computed. Bivariate and multivariate logistic regression was carried out to determine the factors associated with the prevalence of multidrug/rifampicin in the study population. Results: Overall, multidrug/ rifampicin - resistance among suspected drug resistant tuberculosis patients in Botswana were found in 139 (5.4%) cases with 1.3% among new cases and 7.7% among previously treated tuberculosis patients. Being a previously treated tuberculosis patient and having a positive smear were found to be factors associated with the prevalence of multidrug/rifampicin-resistant tuberculosis (p < 0.05). However, age, sex, living in urban area and HIV status were not associated with this disease (p > 0.05). Conclusion: This study highlights a low burden of multidrug/rifampicin resistant tuberculosis among suspected drug resistant tuberculosis patients receiving care at public health facilities in Botswana. Strategies in controlling MDR/RR-TB should emphasize on effective implementation of Directly Observation Treatment - short course strategy, continuous surveillance of drug resistance cases, prevention of the development of new cases of MDR/RR-TB and to treat existing patients. Further interventions should focus on strengthening TB infection control activities.