Sasiwan Homkaew.. Factors associated with drug-resistant tuberculosis of tuberculosis patients in prisons in Thailand. Master's Degree(Epidemiology). Mahidol University. Mahidol University Library and Knowledge Center. : Mahidol University, 2012.
Factors associated with drug-resistant tuberculosis of tuberculosis patients in prisons in Thailand
Abstract:
This retrospective cohort study aimed to determine prevalence of drugresistant tuberculosis in prisons and to examine risk factors associated with drugresistant tuberculosis in prisoners. The subjects were pulmonary tuberculosis (TB) patients who were registered from 1 Jan 2008 to 31 Dec 2010 in 10 prisons of Thailand. A total of 1332 TB patients were registered, of which 493(37%) had sputum culture testing. Of 347 new TB cases, 461(93.5%) had culture and DST performed. Prevalence of resistance to one or more drugs among new and previously treated was 21.6% (75/347) and 33.3% (38/114), respectively. It was found that prevalence of MDR-TB among new and previously treated were 4.32% (15/347) and 24.56% (28/114), respectively. The history of previous treatment was the only factor that was associated with drug resistant tuberculosis and MDR-TB. The researcher recommended that the National Health Security Office Thailand (NHSO) should support the program of culture and DST for all TB patients in prison. Early detection and management of MDR-TB can prevent the transmission in prisons. The National Tuberculosis Program Thailand (NTP) and Department of Correction must seriously implement interventions to prevent MDR-TB outbreak. The interventions include capacity building of prison nurses to handle any MDR-TB cases, and provide effective care, as well as provision of access to culture & DST for all prisoners with TB.