In Egypt, Tuberculosis is considered to be the third most important

communicable disease problem.

Drug-resistant TB (DR-TB) threatens global TB control and is a major
public health concern in several countries. based on routine drug
susceptibility test (DST) of TB patients and systematic collection and
analysis of data is the most effective approach to monitoring.
Diagnosis of drug resistant TB depends on clinical history of previous
treatment of active TB, failure of TB treatment or contact with a patient
with drug resistant TB. Also depends on clinical presentations,
radiological investigations and microbiological evaluations. It also
depends upon culture and sensitivity testing of sputum.
 The aim of this work was to detect the pattern of prevalence, risk
factors and treatment outcomes among Egyptian patients with MDR-
TB previously or currently admitted to different chest sanatoria in
Egypt starting from January 2006 through August 2015.
Patients
This retrospective study included all patients with MDR-TB;
admitted to the following hospitals from January 2006 to August
2015

Methods
This is a multi-center, observational, hospital-based, retrospective
study. Approval of the local ethical committee in Alexandria Faculty
of Medicine (AFM) was taken.
All les of MDR-TB patients were reviewed and data were collected
and analyzed for the following:
1. Demographic data
2. Type of resistance either primary or secondary resistance.
3. Regimens of previous anti-TB treatments received either category I
, category II both;
4. Type of patients (new cases, relapse, defaulters or failure of
treatments);
5. Risk factors for the development of nonresponsiveness to the rst
line treatment for TB as poor adherence to treatment, associated
comorbidities and side effects of drugs.
6. Place of previous anti-TB treatments.
7. duration and doses of previous anti-TB treatments.
 8. Patients compliance either regular or irregular drug intake.
9. Clinical (general and local chest) examinations.
10. Laboratory investigations
11. Microbiological investigations
12. Tuberculin skin testing
13. drug susceptibility tests for the rst and second lines anti-TB
drugs.
14. Radiological investigations
15. Associated co-morbidities
16. Complications of drugs
17. Fate of treatment
 By using retrospective data, encountering instances of missing
patient treatment records, missing data on specic variables and
information on behavioral risk factors.
Furthermore, it was not possible to perform qualitative causality
assessment of the adverse events using the available data.
Some symptoms of reported adverse events may have overlapped
with symptoms of the comorbidities.
 In conclusion, MDR-TB is liable to occur in retreatment cases.
The most common type of resistance was acquired resistance because
of lack of adherence to treatment or inappropriate treatment.
The highest gures of resistance in the MDR-TB cases were acquired
resistance to rifampicin, isoniazid, ethambutol and streptomycin
(RHES).
The most common complications of the second line anti-tuberculous
drugs were gastritis followed by peripheral neuritis.
The prevalence of MDR-TB in Egypt is rising.
Therefore, Emergence of MDR-TB has the potential to be a serious
public health problem in Egypt that necessitates strengthened TB
control and improved continuous monitoring of therapy.