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Background <p>Drug-resistant tuberculosis (DR-TB), encompassing multidrug-resistant (MDR-TB) and extensive drug-resistant (XDR-TB) forms, remains a challenge to global TB control. In India, DR-TB presents a substantial public health concern; however, regional data on associated risk factors are scarce. This study aims to identify socio-demographic, clinical, and treatment-related risk factors for the development of Drug Resistant-TB among patients in Vadodara, Gujarat, India.</p> Methods <p>A retrospective case-control study was conducted using patient records from the District TB Centre, Vadodara, for 2021. Cases (<i>n</i> = 31) comprised all microbiologically confirmed MDR/XDR-TB patients, while controls (<i>n</i> = 93) were randomly selected drug-susceptible TB (DS-TB) patients at a 1:3 ratio. Data on demographics, comorbidities, treatment adherence, and environmental factors were extracted and analyzed using descriptive statistics, chi-square tests, and multivariate regression.</p> Results <p>The most significant independent risk factors for DR-TB included a previous history of TB (adjusted OR 18.5), contact with a known DR-TB case (aOR 4.0), overcrowded living conditions (aOR 3.9), and the lowest socioeconomic class (aOR 3.6). The adherence emerged as the strongest protective factor (aOR 0.02). No significant associations were identified for age, gender, education, marital status, smoking, alcohol use, comorbidities, or BCG vaccination.</p> Conclusions <p>A history of prior TB, close contact with DR-TB cases, overcrowded living conditions, and low socioeconomic status significantly increase the risk of developing DR-TB, whereas high treatment adherence offers substantial protection. Enhancing adherence support, implementing targeted interventions for high-risk groups, and improving living conditions are essential strategies for controlling DR-TB in India.</p>

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Risk Factors for the Development of Drug-Resistant Tuberculosis: A Retrospective Case-Control Study

  • 期刊论文

  • 发表日期：

    2026年5月7日

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  • Umesh Chhotala,
  • Niraj Bharadva,
  • Prashant Dave,
  • Pranav Kshtriya,
  • Utkarsh Shah

摘要

Background

Drug-resistant tuberculosis (DR-TB), encompassing multidrug-resistant (MDR-TB) and extensive drug-resistant (XDR-TB) forms, remains a challenge to global TB control. In India, DR-TB presents a substantial public health concern; however, regional data on associated risk factors are scarce. This study aims to identify socio-demographic, clinical, and treatment-related risk factors for the development of Drug Resistant-TB among patients in Vadodara, Gujarat, India.

Methods

A retrospective case-control study was conducted using patient records from the District TB Centre, Vadodara, for 2021. Cases (n = 31) comprised all microbiologically confirmed MDR/XDR-TB patients, while controls (n = 93) were randomly selected drug-susceptible TB (DS-TB) patients at a 1:3 ratio. Data on demographics, comorbidities, treatment adherence, and environmental factors were extracted and analyzed using descriptive statistics, chi-square tests, and multivariate regression.

Results

The most significant independent risk factors for DR-TB included a previous history of TB (adjusted OR 18.5), contact with a known DR-TB case (aOR 4.0), overcrowded living conditions (aOR 3.9), and the lowest socioeconomic class (aOR 3.6). The adherence emerged as the strongest protective factor (aOR 0.02). No significant associations were identified for age, gender, education, marital status, smoking, alcohol use, comorbidities, or BCG vaccination.

Conclusions

A history of prior TB, close contact with DR-TB cases, overcrowded living conditions, and low socioeconomic status significantly increase the risk of developing DR-TB, whereas high treatment adherence offers substantial protection. Enhancing adherence support, implementing targeted interventions for high-risk groups, and improving living conditions are essential strategies for controlling DR-TB in India.