Prevalence and Risk Factors of Multidrug-Resistant Tuberculosis (MDR-TB) in India: A Cross-Sectional Study in High-Burden Districts

Abstract

Background: Multidrug-resistant tuberculosis (MDR-TB) is a global health challenge, especially in high-burden countries like India, which contributes 26% of the world’s TB cases. MDR-TB, defined by resistance to rifampicin and isoniazid, poses significant treatment difficulties due to prolonged and toxic regimens. Understanding local epidemiology and risk factors is crucial for public health interventions in India. Methods: This cross-sectional study was conducted in high-burden districts of TB hospital of Mumbai,  Maharashtra, India, targeting 128 smear-positive pulmonary TB patients aged 16 years and above. Socio-demographic and clinical data, including treatment history, smoking status, and HIV status, were collected through the patient’s clinical records. GeneXpert MTB/RIF was used for rifampicin resistance testing, and further drug susceptibility tests on Lowenstein-Jensen media were performed to confirm MDR-TB cases. Logistic regression was applied to identify risk factors associated with MDR-TB. Results: The overall prevalence of MDR-TB was 6.3%, with a higher prevalence among retreatment cases (16.2%) compared to new TB cases (2.2%). Males represented 87.5% of MDR-TB cases, and rural residents accounted for 62.5%. The key risk factor identified was a history of previous TB treatment, with these patients being 7.5 times more likely to develop MDR-TB (OR = 7.50, 95% CI: 1.50–40.00, p = 0.031). No significant associations were found between MDR-TB and other factors like gender, education level, or HIV status. Conclusion: This study highlights the significant role of prior TB treatment in the development of MDR-TB in  districts of TB hospital of Mumbai, India. Strengthened control measures, improved treatment adherence, and expanded diagnostic capacity are critical to curbing the MDR-TB epidemic, particularly in rural and underserved regions.