Discussion Topic for Seminar 7 (Presented by Farkhan)

[ABDILLAH FARKHAN]

Article: Using Bayesian spatial models to map and to identify geographical hotspots of MDR-TB in Portugal between 2000 and 2016

Topic for Discussion :

1. What factors contribute to the high incidence of drug-resistant Tuberculosis in an area?

2. If your living area is identified with a high risk for MDR-TB, what is your idea (regarding intervention strategies) to reduce the risk?

[Zarni Lynn Kyaw]

1) I think the following are the factors contribute to the high incidence of drug-resistant Tuberculosis,

Previous history of TB treatment. People who have been treated for TB in the past are more likely to develop MDR-TB, because the bacteria may have become resistant to the drugs used in their previous treatment.

Direct contact with someone with MDR-TB. The most common way to get MDR-TB is through close contact with someone who has the disease. If you are exposed to MDR-TB bacteria, your risk of developing the disease is higher if you have a weakened immune system.

Living in a crowded or poorly ventilated area. MDR-TB bacteria can spread through the air, so people who live in crowded or poorly ventilated areas are at an increased risk of exposure.

HIV infection. People who are HIV-positive are more likely to develop MDR-TB than people who are HIV-negative. This is because HIV weakens the immune system, making it more difficult to fight off the TB bacteria.

Lack of access to quality healthcare. People who do not have access to quality healthcare are more likely to develop MDR-TB, because they may not be able to get the right treatment or they may not be able to complete their treatment course.

Poor infection control practices. Poor infection control practices, such as not wearing a mask when you are around someone who has TB, can also increase your risk of developing MDR-TB.

2) Some intervention strategies that could be used to reduce the risk of MDR-TB in a high-risk area are

Increase awareness of MDR-TB and its symptoms. Many people are not aware of the symptoms of MDR-TB, which can make it difficult to diagnose and treat. Increasing awareness of MDR-TB and its symptoms can help people to seek medical attention early, which can improve their chances of successful treatment.

Screen high-risk populations. Some populations are more at risk of developing MDR-TB than others. These include people who are HIV-positive, people who inject drugs, and people who are incarcerated. Screening these high-risk populations for MDR-TB can help to identify cases early and prevent the spread of the disease.

Improve access to quality healthcare. People who live in high-risk areas may not have access to quality healthcare. This can make it difficult to diagnose and treat MDR-TB. Improving access to quality healthcare in high-risk areas can help to ensure that people who are infected with MDR-TB receive the care they need.

Strengthen infection control measures. Infection control measures can help to prevent the spread of MDR-TB. These measures include things like isolating patients with MDR-TB, using personal protective equipment, and cleaning and disinfecting surfaces. Strengthening infection control measures in high-risk areas can help to reduce the risk of MDR-TB transmission.

[Boonyarat Kanjanapongporn]

From question 2, In high-risk area of MDR-TB, it would probably be worth to detect the strains which cause the MDR. Therefore, the medical team can treat MDR patients with susceptible antibiotics which would enhance the successful treatment and reduce the hospitalization time of patients.

[SIPPAPAS WANGSRI]

1. What factors contribute to the high incidence of drug-resistant Tuberculosis in an area?
To answer this question generally, in Thailand, I’ve found that drug-resistant TB most commonly results from inappropriate use of antibiotics. I also recently found out that “Levofloxacin”, which also one of the alternate regimen for MDR-TB, is also openly sold in some pharmacy store without prescription for “sore throat”. It is highly possible that in the future, there will be much more incidence of antimicrobial resistance.

2. If your living area is identified with a high risk for MDR-TB, what is your idea (regarding intervention strategies) to reduce the risk?
I think we should identify and isolate those who have MDR-TB and put the resistant-strain on watchlist.

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