Tuberculosis killed more people in 2018 than any other single infectious disease. In recent years, there has been an upsurge in cases of drug-resistant tuberculosis. Considering both that antibiotic resistance has been described as a global crisis, and that strains of tuberculosis resistant to all forms of treatment have begun to emerge, there is an urgent need to assess the risk factors for tuberculosis that is completely resistant to treatment. This review analyzed 16 articles that examined relevant risk factors. The most commonly reported risk for patients was having a history of tuberculosis. Other important risk factors were having untreated human immunodeficiency virus (HIV), having a history of incarceration, being male, middle-aged, a smoker, and unemployed. As well, it is not certain if alcoholism, having HIV that is treated, and abnormal body mass increase risk. The findings show that it is crucial that efforts be made to increase adherence to treatment amongst tuberculosis patients. As well, it is critical that HIV programs be scaled up in areas where both diseases are endemic and that more efforts be made to raise awareness about smoking as a risk factor. More studies on risk factors for patients need to be conducted in India and Russia, two countries with some of the highest total cases of drug-resistant tuberculosis. Lastly, there is a need for standardization among studies, and new terms to describe the highest levels of drug-resistant tuberculosis. I recommend the terms extra-extensively drug-resistant tuberculosis (XXDR-TB) and incurable drug-resistant tuberculosis (IDR-TB) be used.
Varshney, Karan; Frasso, PhD, CPH, Rosemary; and Leader, DrPH, MPH, Amy, "Risk Factors For Incurable Drug-Resistant Tuberculosis" (2020). Master of Public Health Capstone Presentations. Presentation 355.