The magnitude and associated factors of drug resistant tuberculosis among children and adolescents who had history of contact with drug resistant tuberculosis diagnosed caretaker or a household member in St Peter & Alert Specialized Hospitals, MDR-TB Treatment Centers, Addis Ababa

Abstract

Abstract Background: Increasing drug resistance rate to first line anti tuberculosis infection drugs is challenging global tuberculosis control programs. The problem is intense when it comes to children and adolescents due to increased vulnerability associated with age (mainly children <5 years of age) and difficulties associated with process of diagnosis (availability of appropriate specimen for diagnosis), and poor housing conditions. Objective: The major objective of this study is to assess the magnitude and associated factors of drug resistant TB infection among children and adolescent age group and also to determine the prevalence of drug resistant tuberculosis among children and adolescents who had history of contact with index case (diagnosis confirmed drug-resistant TB patient) in St Peter and Alert specialized hospitals Drug-resistant TB treatment centers Addis Ababa. Methods: The list of all index cases was prepared from the electronic medical records of drug-resistant TB-diagnosed caregivers (index cases) to prepare the sampling frame of contacts. A total of 288 (186 from St. Peter and 102 from ALERT hospitals) contacts were identified. The sampling units were divided by the two study sites based on the probability proportional to size sampling method to determine the minimum sample size for the study. Then The data was collected by trained professionals working in the treatment centers using a medical record data abstraction tool and an interview guide questionnaire within a period of four months (November 7 up to the end of February 2021). Results: The overall prevalence of drug-resistant tuberculosis was 6.6% (12/183) among the participants (CI: 1.03, 1.10). Participants with a history of previous tuberculosis treatment (AOR = 6.76, 95% CI: 2.542, 17.98) and moderate malnutrition (AOR = 0.01, 95% CI: 0.01, 0.108) had a higher risk of drug-resistant tuberculosis. Conclusions: There is a high prevalence of drug-resistant TB among children and adolescents in household contacts of drug-resistant TB patients diagnosed as index patients in St. Peter's and Alert DR/MDR-TB treatment centers. Proper tracing and meticulous follow-up of children and adolescent age group contacts of MDR-TB index cases could be a high-yield strategy for early detection and treatment of MDR-TB cases in the community...................Thesis available at Addis Continental Institute of Public Health Library