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Risk factors for drug resistant tuberculosis in Leicestershire – poor adherence to treatment remains an important cause of resistance

Published online by Cambridge University Press:  25 June 2003

A. J. PRITCHARD ,
A. C. HAYWARD ,
P. N. MONK  and
K. R. NEAL
A. J. PRITCHARD
Affiliation:
Bassetlaw Primary Care Trust, c/o Ransom Hall, Southwell Road West, Rainworth, Mansfield, Nottinghamshire, NG21 0ER
A. C. HAYWARD
Affiliation:
Centre for Infectious Disease Epidemiology, University College London, Department of Primary Care and Population Sciences, Royal Free Hospital, Rowland Hill Street, London NW3 2PF
P. N. MONK
Affiliation:
Leicestershire, Northamptonshire and Rutland, Health Protection Team, Gwendolen Rd, Leicester LE5 4QF
K. R. NEAL
Affiliation:
Division of Public Health Sciences, School of Community Health Sciences, University of Nottingham Medical School, Nottingham NG7 2UH
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Abstract

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In the light of rising numbers of tuberculosis (TB) cases in the United Kingdom, the problem of anti-tubercular drug resistance remains a significant concern. Drug resistant TB cases are more difficult and costly to treat, and require appropriate treatment and control mechanisms. This matched case control study aimed to investigate risk factors for resistance in Leicestershire, using data for laboratory isolates of Mycobacterium tuberculosis identified from 1993 to 1998. Each case, defined as culture positive laboratory isolates resistant to at least one first-line drug, was matched to four fully sensitive controls on age, sex and ethnic group. Twenty-three cases and 81 controls were included in the analysis. Drug resistance in Leicestershire was found to be associated with poor adherence to treatment (OR 4·8, 95% CI 1·6–14·4, P=0·005) and with previous TB (OR 3·7, 95% CI 1·2–11·8, P=0·022). These findings emphasize the need to provide support to patients taking treatment in order to maximize adherence.

Type
Research Article
Information
Epidemiology & Infection , Volume 130 , Issue 3 , June 2003 , pp. 481 - 483
Copyright
© 2003 Cambridge University Press