Multidrug-resistant tuberculosis in Belarus: the size of the problem and associated risk factors
Alena Skrahina, Henadz Hurevich, Aksana Zalutskaya, Evgeni Sahalchyk, Andrei Astrauko, Sven Hoffner, Valiantsin Rusovich, Andrei Dadu, Pierpaolo de Colombani, Masoud Dara, Wayne van Gemert & Matteo Zignol
Volume 91, Number 1, January 2013, 36-45
Table 4. Risk factors for multidrug resistance among tuberculosis cases, Belarus, 2010–2011
| Characteristic | Cases |
Univariate analysisa |
Multivariate analysisa |
|||||
|---|---|---|---|---|---|---|---|---|
| No. | % with MDR-TB | OR (95% CI) | P | OR (95% CI) | P | |||
| Sex | ||||||||
| Male | 1075 | 47.6 | Ref. | – | Ref. | |||
| Female | 269 | 37.2 | 0.7 (0.5–0.8) | 0.000 | 1.1 (0.8–1.5) | 0.657 | ||
| Age (years) | ||||||||
| 15–34 | 328 | 49.7 | Ref. | – | Ref. | |||
| > 34 | 1016 | 44.2 | 0.8 (0.6–1.0)b | 0.046 | 0.7 (0.6–1.0) | 0.021 | ||
| Country of birth | ||||||||
| Belarus | 1293 | 45.3 | Ref. | – | – | |||
| Other | 51 | 51.0 | 1.3 (0.8–2.0) | 0.360 | – | |||
| Treatment history | ||||||||
| New case | 934 | 32.3 | Ref. | – | Ref. | |||
| Previously treated case | 410 | 75.6 | 6.5 (5.2–8.2) | 0.000 | 6.1 (4.8–7.7) | 0.000 | ||
| Level of education | ||||||||
| University | 43 | 34.9 | Ref. | – | – | |||
| College | 345 | 47.3 | 1.7 (0.9–3.0) | 0.080 | – | |||
| Secondary school | 887 | 46.6 | 1.6 (0.9–2.8) | 0.087 | – | |||
| Primary school or lower | 69 | 30.4 | 0.8 (0.4–1.7) | 0.573 | – | |||
| Living conditions | ||||||||
| In own house | 1104 | 45.7 | Ref. | – | – | |||
| In rented house | 185 | 43.8 | 0.9 (0.7–1.2) | 0.587 | – | |||
| In dormitory | 29 | 37.9 | 0.7 (0.4–1.4) | 0.345 | – | |||
| Homeless | 26 | 61.5 | 1.9 (1.0–3.8) | 0.069 | – | |||
| Household size (no. of members) | ||||||||
| 1 | 329 | 49.9 | Ref. | – | Ref. | |||
| 2 | 543 | 46.0 | 0.9 (0.7–1.1) | 0.209 | 1.0 (0.7–1.3) | 0.758 | ||
| 3 | 287 | 42.9 | 0.8 (0.6–1.0)b | 0.046 | 0.8 (0.6–1.1) | 0.184 | ||
| > 3 | 185 | 40.5 | 0.7 (0.5–0.9) | 0.020 | 0.8 (0.6–1.2) | 0.266 | ||
| Employment status | ||||||||
| Employed | 401 | 42.4 | Ref. | – | Ref. | |||
| Unemployed but able-bodied | 659 | 50.5 | 1.4 (1.1–1.7) | 0.003 | 1.1 (0.8–1.4) | 0.578 | ||
| Retired | 175 | 27.4 | 0.5 (0.4–0.7) | 0.000 | 0.7 (0.5–1.0) | 0.052 | ||
| Unemployed due to disability | 87 | 59.8 | 2.0 (1.3–3.0) | 0.001 | 1.9 (1.2–3.0) | 0.010 | ||
| Student | 22 | 40.9 | 0.9 (0.4–2.0) | 0.874 | 1.4 (0.6–3.2) | 0.417 | ||
| History of imprisonment | ||||||||
| No | 1145 | 42.2 | Ref. | – | Ref. | |||
| Yes | 199 | 64.8 | 2.5 (1.9–3.3) | 0.000 | 1.5 (1.1–2.0) | 0.009 | ||
| Alcohol consumption (days of binge drinking)c | ||||||||
| 0 | 573 | 40.0 | Ref. | – | Ref. | |||
| 1 | 61 | 39.3 | 1.0 (0.6–1.6) | 0.914 | 1.0 (0.6–1.7)b | 0.977 | ||
| 2–4 | 264 | 45.1 | 1.2 (1.0–1.6) | 0.109 | 1.0 (0.8–1.4) | 0.770 | ||
| > 4 | 446 | 53.8 | 1.8 (1.4–2.2) | 0.000 | 1.3 (1.0–1.8) | 0.038 | ||
| History of smokingd | ||||||||
| No | 288 | 31.6 | Ref. | – | Ref. | |||
| Yes | 1056 | 49.3 | 2.1 (1.7–2.7) | 0.000 | 1.5 (1.1–2.0) | 0.021 | ||
| HIV status | ||||||||
| Negative | 1249 | 44.6 | Ref. | – | Ref. | |||
| Positive | 72 | 68.1 | 2.6 (1.7–4.1) | 0.000 | 2.2 (1.4–3.5) | 0.001 | ||
| Unknown | 23 | 26.1 | 0.4 (0.2–1.0)b | 0.047 | 0.5 (0.2–1.3) | 0.173 | ||
CI, confidence interval; MDR-TB, multidrug-resistant tuberculosis; OR, odds ratio; Ref., reference group.
a All determinants were studied by logistic regression. Those whose P-value showed statistical significance (P < 0.05) in the univariate analysis were included in the multivariate analysis.
b The CI contains the number 1.0 because of rounding.
c Reported as the number of days in the previous month when the patient drank at least 5 units of alcohol.
d “Smoking” is here defined as the regular use of any tobacco product in the previous 5 years.