Asian Research Thesis Index

Abstract

INTRODUCTION Tuberculosis is a chronic infectious bacterial disease caused by Mycobacterium tuberculosis. Multi drug resistant tuberculosis is a form of tuberculosis caused by a strain of Mycobacterium tuberculosis complex which are resistant to at least Isoniazid and Rifampicin with or without resistance to any other first line antituberculosis treatment (ATT). Multiple factors have been identified those lead to multi drug resistance response to tuberculosis. Treatment of multi-drug resistant tuberculosis requires treatment with second line drugs, usually four or more TB drugs for a minimum period of 6 months and probably extending for 18-24 months if rifampicin resistance has been identified. Linezolid is an antibiotic used for the treatment of serious infections caused by gram positive bacteria and in highly resistant tuberculosis strain and cases that are otherwise complicated to treat. OBJECTIVES The objectives of this study were to determine the demographic features of participants in this study, to determine risk factors in multi-drug resistant tuberculosis and to conduct a clinical trial for the determination of efficacy of linezolid in patients with multi drug resistant tuberculosis. Study design; To determine the demographic features of Tuberculosis, cross sectional study, to determine the risk factors in patients with Tuberculosis and multi-drug resistant Tuberculosis, analytical cross sectional study and to conduct the clinical trial for examining the efficacy of Linezolid for treatment of multi drug resistant tuberculosis, clinical trial was conducted by using the study design of experimental epidemiology (Single blind randomized control trial phase-4) Study Universe: Public sector Hospital, Lahore Pakistan. Study population: Tuberculosis and multi-drug resistant tuberculosis patients registered or followed by Outpatient Department of public sector Hospital Lahore Sampling Technique;: Convenient sampling for project-1 & 2 and Simple Random Sampling for project-3 Study Duration: One year (1st Dec 2016 to 30th Nov2017) DATA COLLECTION PROCEDURE; using convenient sampling/simple random sampling technique, data collected through a questionnaire. Subjects from public sector hospital were enrolled in the study according to inclusion and exclusion criteria. They were investigated, examined, monitored and data recorded in a questionnaire. Statistical analysis was done using SPSS version RESULTS; During demographic analysis of patients with tuberculosis, it was observed that female cases were higher than male cases. Age group 18-34 years was maximally affected by tuberculosis. The disease had a decreasing trend with aging. In both genders number of cases was decreasing with increase of age. There were only a few cases above 60 years of age. Majority of cases belonged to Lahore or its suburbs. . Majority of the cases belonged to urban area, had lower class and low socioeconomic status. Males were more educated as compared to females. Majority of the cases were relapsed. Two third cases had extra pulmonary Tuberculosis. In extra pulmonary tuberculosis, majority of cases involved lymph nodes. The risk factors for tuberculosis and multi-drug resistant tuberculosis were not common. In randomized control trial with Linezolid, 90% cases of multi-drug resistant tuberculosis were pulmonary tuberculosis. Treatment with Linezolid proved to be effective in 60% cases. CONCLUSION; In this study analysis of demographic profile showed that the number of female patients was increasing. The age group 18-44 years was maximally affected. In randomized control trial with Linezolid, 90% cases of multidrug resistant tuberculosis were pulmonary. Treatment with Linezolid proved to be effective in 60% cases with multi-drug resistant tuberculosis.

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