RESUMEN
SETTING: Pakistan ranks sixth in the world in terms of tuberculosis (TB) burden, with a World Health Organization estimated incidence of 181 per 100000, or 286000 new cases annually. Hospital-based data indicate a significant problem of multidrug-resistant TB (MDR-TB) in the country and highlight the need to assess its extent at community level. In this cross-sectional study, sputum samples from 742 untreated newly diagnosed pulmonary TB patients from all over the country were used. OBJECTIVE: To assess the prevalence of primary drug resistance in Pakistan. RESULTS: Of 672 culture-positive patients, 76 (11.3%) showed resistance to one or more drugs. Resistance to streptomycin (10 microg/ml) was found in 36 (5.4%) patients, isoniazid (INH) (1 microg/ml) in 51 (7.6%), rifampicin (RMP) (5 microg/ml) in 15 (2.2%), ethambutol (10 microg/ml) in 12 (1.8%) and pyrazinamide in 22 (3.3%) samples. Forty-six (6.8%) of the isolates tested were resistant to a single drug, 10 (1.5%) to two drugs, 12 (1.8%) to three drugs, and 6 (0.9%) to four drugs, while 2 (0.3%) isolates were resistant to all five first-line agents. Primary MDR-TB was 1.8% (n=12) (INH 1 microg/ml, RMP 5 microg/ml). CONCLUSION: The results of this study show a prevalence of primary MDR-TB in Pakistan of <2%, which needs to be addressed through an effective DOTS strategy.
Asunto(s)
Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tuberculosis Pulmonar/epidemiología , Adolescente , Adulto , Antituberculosos/farmacología , Estudios Transversales , Farmacorresistencia Bacteriana Múltiple , Femenino , Humanos , Masculino , Mycobacterium tuberculosis/efectos de los fármacos , Pakistán/epidemiología , Prevalencia , Esputo/microbiología , Tuberculosis Pulmonar/tratamiento farmacológicoRESUMEN
Various cold stain techniques have been tried with varying success since early part of the century. Dr. S. Kudoh of Japan and Dr. A. J. Pathan of Pakistan discussed to evolve a simple process for cold method (see the foot note) which is a simple procedure for staining tubercle bacilli in sputum specimen. And the cold method was found as sensitive, as specific and almost as reliable as Ziehl Neelsen on direct comparison of two techniques. In this paper, the cold method was further evaluated on culture results with Ziehl Neelsen stain during 1987-90 in our institute.
