Mapping the geographical spread of multi-drug resistance tuberculosis patients for effective control and prevention in Tanzania

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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
University of Dar es Salaam
Abstract
The tuberculosis (TB)-causing bacteria can become drug-resistance. More complicated is Multi-drug-resistant TB (MDR-TB) is a kind of TB non-responsive to at least ‘isoniazid’ and ‘rifampicin’. This study was carried out to determine the geographical distribution of multi-drug resistant tuberculosis (MDR-TB) patients in Tanzania’s four Regions of Dar es Salaam, Mbeya, Kilimanjaro and Geita regions as in addition to determining the likely risk factors associated with such incidences. This ecological study was carried out by deploying data on patients diagnosed with MDR-TB from the Central Tuberculosis Reference Laboratory (CTRL) covering a period of January 2015 - December 2017. Four regions with the highest TB prevalence were purposively selected, Ward and District level population data were extracted from the TB Registers (TBR). The study reviewed laboratory Drug Sensitivity Test (DST) records to locate MDR-TB participants reported at the Central Tuberculosis Reference Laboratory (CTRL). Another record review of “TB patient Treatment Card” was used to collect the patients’ demographics information. Thematic maps were created to enable visualisation of the distribution of MDR-TB patients’. Trend analysis maps for the Geographical Spread of MDR-TB were used to analyse the spatial temporal variation of MDR-TB spread from 2015-2017. Multivariate regression analysis was used to explore the factors leading to MDR-TB spread. Consequently, of interest to the study were 430 MDR-TB and TB patients, who were diagnosed as new and previously treated TB cases. The study participants’ mean age was 37 whereas the median age stood at 36 years (STDEVA=14, SE=0.90, 95%CI= 35.04- 38.59). Male to female ratio of study participants was 2:1.The study shows that the odds of having MDR-TB among retreatment TB- patients was statistically and significantly higher than in non-retreatment TB cases (p<0.0001). Moreover, Retreatment TB patients were 25-times more likely to develop MDR-TB than non-retreatment TB-patients (AOR= 25.29).The study also found that the majority of the patients with MDR-TB notified cases were found in Dar es Salaam (83%) followed by Geita (10.1%), and Mbeya (6.7%). Kilimanjaro, on the other hand, did not have a reported case in 2017. The majority of MDR-TB patients happened to be male and these were largely stationed in the sprawling city of Dar es Salaam and to a certain extent Geita, a hub of commercial mining, compare to other regions. Thus there is need to encourage males to utilise TB services by screening for TB and registering with TB-clinic. The study recommends strengthening of MDR-TB surveillance among previously treated TB Cases, Males and active MDR-TB case finding among HIV infected TB patients.
Description
Available in print form, East Africana Collection, Dr. Wilbert Chagula Library, Class mark (THS EAF QR82.M8.T34E552)
Keywords
geographical, control
Citation
Emmanuel, G (2019) Mapping the geographical spread of multi-drug resistance tuberculosis patients for effective control and prevention in Tanzania, Master dissertation, University of Dar es Salaam. Dar es Salaam.