Risk factors for multidrug-resistant tuberculosis in Hong Kong

• Published in: The international journal of tuberculosis and lung disease Vol. 12; no. 9; pp. 1065 - 1070
• Main Authors: LAW, W. S, YEW, W. W, CHIU LEUNG, C, KAM, K. M, TAM, C. M, CHAN, C. K, LEUNG, C. C
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.09.2008; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Adult; Aged; Antitubercular Agents - therapeutic use; Bacterial diseases; Biological and medical sciences; Case-Control Studies; Confidence Intervals; Emigration and Immigration; Female; Hong Kong; Hong Kong - epidemiology; Human bacterial diseases; Humans; Infectious diseases; Logistic Models; Male; Medical sciences; Middle Aged; Miscellaneous; Multidrug-Resistant; Mycobacterium; Odds Ratio; Pneumology; Prevalence; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries; Risk Factors; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Multidrug-Resistant - epidemiology; Hong Kong; Asia; China; China, People's Rep., Hong Kong; Human; Treatment resistance; risk factors; Hong Kong; Mycobacterial infection; multidrug-resistant; Infection; Tuberculosis; Mycobacterium tuberculosis; Mycobacteriales; Multiple resistance; Risk factor; Bacteriosis; Mycobacteriaceae; Bacteria; Actinomycetes; Antibacterial agent; Pneumology
• ISSN: 1027-3719; 1815-7920

SETTING: Previous anti-tuberculosis treatment is a widely reported risk factor for multidrug-resistant tuberculosis (MDR-TB), whereas other risk factors are less well described. In Hong Kong, the clinical characteristics of MDR-TB have not been systematically evaluated.OBJECTIVE: To explore the risk factors for MDR-TB in Hong Kong.DESIGN: MDR-TB patients treated between 1999 and 2003 were compared with non-MDR-TB patients by stratification of previous anti-tuberculosis treatment.RESULTS: One hundred and fifty-six MDR-TB patients, including 93 with and 63 without a previous history of anti-tuberculosis treatment, were identified. Among the 322 non-MDR-TB controls, respectively 192 and 130 patients did and did not have a previous history of anti-tuberculosis treatment. Using logistic regression analysis, non-permanent residents (OR 6.85, 95%CI 1.38-34.09), frequent travel (OR 2.48, 95%CI 1.07-5.74) and younger age were found to be independent predictors of MDR-TB in previously treated patients, whereas living on financial assistance just failed to reach statistical significance (OR 2.75, 95%CI 0.98-7.68, P = 0.05). In the treatment-naïve group, despite significant differences in baseline characteristics among MDR-TB and non-MDR-TB patients, no independent predictor variables could be identified.CONCLUSION: In Hong Kong, non-permanent residents, frequent travel and young age were independent predictors of MDR-TB among previously treated patients.