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Factors associated with isoniazid resistant tuberculosis among human immunodeficiency virus positive patients in Swaziland: A case-control study

BMC Infectious Diseases Aug 28, 2019

Dlamini NC, Dar-Der Ji, DD, Chien LY, et al. - Researchers conducted a case-control study in nine healthcare facilities across Swaziland to assess risk factors correlated with isoniazid-resistant tuberculosis among HIV positive patients. Patients with isoniazid-resistant tuberculosis were included as cases (78 patients with isoniazid mono-resistant tuberculosis, 42 with polydrug-resistant tuberculosis, and 77 with multidrug-resistant tuberculosis). Presumed drug-susceptible tuberculosis patients (n = 203) were the controls. Observations revealed a positive correlation of history of previous tuberculosis treatment with either isoniazid mono or poly drug-resistant tuberculosis and multidrug-resistant tuberculosis. Further, patients from rural areas and who were current heavy alcohol drinkers had a higher likelihood of being having isoniazid mono or poly resistant tuberculosis vs those who had drug-susceptible tuberculosis. Multidrug-resistant tuberculosis patients vs drug-susceptible tuberculosis group were more likely to be non-adherent to tuberculosis treatment. Findings thereby emphasize strengthening the use of rapid diagnostic tests in the tuberculosis program with early detection of resistance, prompt initiation of supervised tuberculosis treatment and decentralized quality tuberculosis services to the rural areas.

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