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Multidrug-resistant Tuberculosis Patients in Bhutan, August 2011 to July 2012

This study aimed to describe the factors associated with multidrug-resistant tuberculosis (MDR-TB) in Bhutan. The study covered all MDR-TB patients admitted to Gidhakom Hospital, Thimphu from August 2011 to July 2012. Data were collected from MDR-TB registers, laboratory registers and inpatient records as well as from interview with patients about demographic characteristics, history of previous anti-TB treatment, compliance and contact history. There were total 19 MDR-TB patients. Majority of the patients were males (63%). Median age was 25 years for males and 30 years for females. Of the 19 cases, 47% and 37% had contacted with TB case and MDR-TB case in the same house respectively. About 74% reported previous history of anti-TB treatment. Among those with previous treatment, 79% did not comply with the directly observed treatment short-course (DOTS). It was found that 20% of new cases and 50% of previously treated persons were resistant to four first-line drugs. In conclusion, previous anti-TB treatment, non-compliance to DOTS and contact with MDR-TB were observed in majority of the cases. We highlighted the importance of early detection of MDR-TB, providing health education on prevention of disease transmission and strengthening DOTS policy. Investigation on household contacts should be given priority to identify and control the spread of TB.
Keywords: tuberculosis, multidrug-resistant, directly observed treatment short-course, Bhutan