Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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Young age groups and Drug Resistant TB: the Delhi End TB Matrix
Nandini Sharma, Shivani Chandra, Ashwini Khanna

Last modified: 2018-07-23

Abstract


The unprecedented risk of drug resistant TB in young urban dwellers has remained inconspicuous due to growing public health concerns of the disease among the mature reproductive population. When assessed against the backdrop of Ending TB in high burden settings, the socio-demographic influence on the disease curve needs to be fragmented for a more strategic work plan creation. State of Delhi undertook an assessment of drug resistant (DR) TB patients to understand the disease trends, distribution, determinants and the treatment outcomes. Based on knowledge gleaned, policy inputs to enhance DR-TB care by the program were suggested.

Retrospective record based study was undertaken between the years 2009 till 2014 for all DR-TB patients registered under Programmatic Management of DR-TB in Delhi. Program surveillance record for each patient was analysed. Two age groups, Young Age (14-30 years) and Mature Reproductive Age (30-50 years), were studied for age wise epidemiological assessment. Program parameters chosen were successful treatment outcomes, adverse treatment outcomes and improvement in body mass index (BMI). Socio-demographic determinants such as income and spatial details, available in program records, were also assessed. Univariate linear regression was employed to examine the interrelationship between program parameters, socio-demographic determinants and age indices.

Out of the 2958 DR-TB patients whose treatment outcomes were available, 2502 (84.6%) belonged to young age group. This age group showed maximum favorable (64.5%) and minimum adverse outcomes (34.4%) with respect to treatment. Favorable outcomes were associated with improvement in BMI (p<0.05).  Except income, other parameters and determinants showed significant correlation with the young age group.

The study highlights the need for drug resistant strains to be battled through aggressive efforts in order to skew the disease curve for the amenable younger age groups. Rigorous interventions, based on country specific disease transmission dynamics, are needed to reach the End TB targets in high burden settings.