Welcome to International Network for Natural Sciences

Paper Details

Research Paper | March 5, 2022

| Download

Pattern of drug resistance in multi drug resistant tuberculosis patients in Punjab, Pakistan

Salma Hameed, Irfan Ullah, Nasir Mahmood, Asmat Ullah, Muhammad Nawaz Chaudhry, Waqas Ahmad, Muhammad Aqeelur Rehman, Muzammil Ahmad Khan, Muhammad Badar

Key Words:

Int. J. Biosci.11(1), 372-379, July 2017

DOI: http://dx.doi.org/10.12692/ijb/20.2.1-20

Certification: IJB 2017 [Generate Certificate]


The prevalence rate of tuberculosis and drug resistance (DR), especially multi-drug resistant tuberculosis (MDR-TB), is a major public health problem in developing countries like Pakistan. The purpose of the current study was to see the frequency of drug resistance pattern of drug resistance tuberculosis (DR-TB) against 1st line anti-TB drugs. Drug susceptibility testing (DST) was performed for 473confirmed cultured positive isolates using proportion methods. The study period was started from November 2011 to June 2013 at a programmatic management of drug-resistant TB (PMDT) unit, Gulab Devi Chest Hospital Lahore, Pakistan. Out of the total, 291 (61.5%) patients were resistant to at least one anti-TB drugs and 246 (52%) were MDR-TB. Among 291 resistant patients, almost one-third of the patients were resistant to all the first-line drugs (n=113, 38.8%). The other prevalent resistance was found against rifampicin (n=277, 95.2%) and isoniazid (n=255, 87.6%) followed by ethambutol (n=181, 62.2%), streptomycin (n=176, 60.5%) and pyrazinamide (n=175, 60.1%). The proportion of males was relatively higher (n=151, 51.9%) than females, while previously treated patients were 175 (60.1%). Most of the cases were from age group 15-45 (81.1%) years, and belonged to the urban area (88.3%). Our study revealed high prevalence of drug-resistant TB, especially in the previously treated patients and young age peoples. Continuous monitoring of drug-resistant pattern of MDR-TB and their treatment is an essential requirement for future control in developing countries like Pakistan.


Copyright © 2021
By Authors and International Network for
Natural Sciences (INNSPUB)
This article is published under the terms of the Creative
Commons Attribution Liscense 4.0

Pattern of drug resistance in multi drug resistant tuberculosis patients in Punjab, Pakistan

Akhtar S, Haidri FR, Memon AM. 2007. “Original Article Drug Resistance to Tuberculosis in a Tertiary Care Setting in Karachi” The Journal of the Pakistan Medical Association. 57(6), 282–84.PMID: 17629227.

Amjad A, Satti L, Farwa U, Abbasi SA. 2012. “Rising Trend of Multi Drug Resistant Tuberculosis : A Threat to Community” 10(1), 32–36.

Aparna S, Moorthy KVK, Gokhale S. 2006. “From Microscopy Centre to Culture Laboratory: A Viable Ride for Mycobacteria.” International Journal of Tuberculosis and Lung Disease 10(4), 447–49. PMID: 16602411.

Butt T, Ahmad RN, Kazmi SY, Rafi N. 2004. “Multi-Drug Resistant Tuberculosis in Northern Pakistan.” The Journal of the Pakistan Medical Association 54, 469–72.PMID: 15518370.

Chacon L, Lainez M, Rosales E, Mercado, Caminero JA. 2009. “Evolution in the Resistance of Mycobacterium Tuberculosis to Anti-Tuberculosis Drugs in Nicaragua.” The International Journal of Tuberculosis and Lung Disease : The Official Journal of the International Union against Tuberculosis and Lung Disease 13(1), 62–67.PMID: 19105880

Diel R, Vandeputte J, de Vries G, Stillo J, Wanlin M, Nienhaus A. 2014. “Costs of Tuberculosis Disease in the European Union : A Systematic Analysis and Cost Calculation,” 554–65. http://dx.doi.org/10.1183/09031936.00079413.

Qadeer E, Fatima R, Yaqoob A, Tahseen S, Haq MU, Ghafoor A, Asif M, Straetemans M, Tiemersma EW. 2016. “Population Based National Tuberculosis Prevalence Survey among Adults (>15 Years) in Pakistan, 2010–2011.” PLoS ONE 1 11(2), e0148293. http://dx.doi.org/10.1371/journal. pone.0148293.

Hasan R, Jabeen K, Mehraj V, Zafar F, Malik F, Hassan Q, Azam I, Kadir MM. 2009. “Trends in Mycobacterium Tuberculosis Resistance, Pakistan, 1990-2007.” International Journal of Infectious Diseases 13(6). http://dx.doi.org/10.1016/j.ijid.2009.01.008.

Javaid, Arshad. 2015. “Burden of Mdr-Tb and Its its Control in Pakistan.” Pakistan Journal Chest Medicine, No. January 21(04), 131–33.

Javaid A, Khan MA, Khan MA, Mehreen S, Basit A, Khan RA, Ihtesham M, Ullah I, Khan A, Ullah U. 2016. “Screening Outcomes of Household Contacts of Multidrug-Resistant Tuberculosis Patients in Peshawar, Pakistan.” Asian Pacific Journal of Tropical Medicine 9(9), Elsevier B.V.: 909–12. http://dx.doi.org/10.1016/j.apjtm.2016.07.017.

Karamat KA, Shahid Rafi. 1999. “Drug Resistance in Mycobacterium Tuberculosis : A Four Years Experience.” The Journal of the Pakistan Medical Association, 49, 262–65. PMID: 10647236.

Khan MA, Mehreen S, Basit A, Khan RA, Jan F, Ullah I, Ihtesham M, Khan A, Ullah U, Javaid A. 2015. “Characteristics and Treatment Outcomes of Patients with Multi-Drug Resistant Tuberculosis at a Tertiary Care Hospital in Peshawar, Pakistan.” Saudi Medical Journal 36(12), 1463–71, http://dx.doi.org/10.15537/smj.2015.12.12155.

Micheletti VCD, Moreira JDS, Ribeiro MO, Kritski AL, Braga JU. 2014. “Drug-Resistant Tuberculosis in Subjects Included in the Second National Survey on Antituberculosis Drug Resistance in Porto Alegre, Brazil.” J Brasileiro de Pneumologia 40(2), 155–63. PMID: 24831400 PMCID: PMC4083645

Nathanson E, Gupta R, Huamani P, Leimane V, Pasechnikov AD, Tupasi TE, Vink K, Jaramillo E, Espinal MA. 2004. “Adverse Events in the Treatment of Multidrug-Resistant Tuberculosis: Results from the DOTS-Plus Initiative.” International Journal of Tuberculosis and Lung Disease 8(11), 1382–84.PMID: 15581210

Rao NA, Irfan M, Soomro MM, Mehfooz Z. 2010. Drug resistance pattern in multidrug resistance pulmonary tuberculosis patients. Journal of the College of Physicians and Surgeons Pakistan. 20(4), 262-265.

Ruddy M, Balabanova Y, Graham C, Fedorin I, Malomanova N, Elisarova E, Kuznetznov S, Gusarova G, Zakharova S, Melentyev A, Krukova E. 2005. “Rates of Drug Resistance and Risk Factor Analysis in Civilian and Prison Patients with Tuberculosis in Samara Region, Russia,” 60(2), 130–36. http://dx.doi.org/10.1136/thx.2004.026922.

Seema I, Hassan Q, Hasan R. Assessment of resistance in multi drug resistant tuberculosis patients. JOURNAL-PAKISTAN MEDICAL ASSOCIATION. 2006 Sep 1, 56(9), 397-400.PMID: 17091751

Ullah I, Javaid A, Masud H, Ali M, Basit A, Ahmad W, Younis F, Yasmin R, Khan A, Jabbar A, Husain M. Rapid detection of Mycobacterium tuberculosis and rifampicin resistance in extrapulmonary tuberculosis and sputum smear-negative pulmonary suspects using Xpert MTB/RIF. Journal of Medical Microbiology. 2017 Apr 28, 66(4), 412-418. http://dx.doi.org/10.1099/jmm.0.000449.

Ullah I, Javaid A, Tahir Z, Ullah O, Shah AA, Hasan F, Ayub N. 2016a. “Pattern of Drug Resistance and Risk Factors Associated with Development of Drug Resistant Mycobacterium Tuberculosis in,”11(1), 1–7, http://dx.doi.org/10.1371/journal.pone.0147529.

Ullah I, Shah AA, Basit A, Ali M, Ullah U, Ihtesham M, Mehreen S, Mughal A, Javaid A. 2016b. “Rifampicin Resistance Mutations in the 81 Bp RRDR of Rpo B Gene in Mycobacterium Tuberculosis Clinical Isolates Using Xpert MTB / RIF in Khyber Pakhtunkhwa , Pakistan : A Retrospective Study.” BMC Infectious Diseases. BMC Infectious Diseases, 16(1), 4–9, http://dx.doi.org/10.1186/s12879–016–1745–2.

Ullah I, Shah AA, Tahir Z, Hasan F, Ayub N. 2014. “Detection of Mycobacterium Tuberculosis from Clinical Specimens by Conventional and Molecular Technique in Punjab , Pakistan.” Global Veterinaria 13(6), 1002–9, http://dx.doi.org/10.5829/idosi.gv.2014.13.06.9158.

WHO. 2013a. “Global Tuberculosis Report 2013.” World Health Organization, 306. http://dx.doi.org/10.3917/spub.092.0139. 2013b.

WHO. Multidrug-Resistant Tuberculosis in Belarus: The Size of the Problem and Associated Risk Factors.” WHO. World Health Organization. 2014. “Global Tuberculosis Report 2014.” WHO Report 2014 (4),  171. http://dx.doi.org/10.1155/2014/187842.

World Medical Association (WMA). 2009. “Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects.” Jahrbuch Für Wissenschaft Und Ethik 14(1). http://dx.doi.org/10.1515/9783110208856.233.

Li X, Wang H, Jing H, Wang Y, Yu C, Wang J, Liu Z, Graviss EA, Ma X.  2012. “Population-Based Surveillance of Extensively Drug-Resistant Tuberculosis in Shandong,” no. March 2012, 16, 612–14. http://dx.doi.org/10.5588/ijtld.11.0507.


Style Switcher

Select Layout
Chose Color
Chose Pattren
Chose Background