Drug-resistant profile among foreign-born tuberculosis patients in Kuala Lumpur, Malaysia

Background: Statistic showed that foreign-born patients make up thirteen per cent of all tuberculosis (TB) patients in Malaysia. Not only they added to the incidence rate of TB yearly, but also many believed that this group of patients had a significant contribution to the transmission of drug-resistant tuberculosis in the community. However, little is known about the profile of foreign-born drug-resistant patients in Malaysia, and this has become the aims of this current study. Methods and materials: This retrospective cohort study involved foreign-born laboratory-confirmed drug-resistant tuberculosis patients notified in National TB Registry in Klang Valley area from 1st January 2009 to 30th June 2013. This study includes those foreigners living less than ten years in Malaysia and excluding those who live more than ten consecutive years in Malaysia and hold the status of Malaysian permanent resident. Patients’ medical record was reviewed to retrieve their sociodemographic data, clinical history and drug-resistant profile. Data were analysed by using IBM SPSS version 24.0 for Windows. Results: A total of 12,799 tuberculosis patients with a positive culture of Mycobacterium tuberculosis were screened for drug and sensitivity testing in this period. 526 (4.1%) patients were resistant to at least one first-line anti-tuberculosis drugs with 38.2% (n = 201) of them were foreigners. Their mean age was 34.52 ± 11.32 years old. Out of 201 patients analysed, 67.2% (n = 135) of them were mono-resistant, 10.9% polyresistant and 21.9% (n = 44) were multi-drug resistant tuberculosis patients. Among the mono-resistant TB patients, 10.4% and 2.2% of them showed mono-resistance to two most potent first-line anti-TB drugs; Isoniazid and Rifampicin respectively. Resistance to Isoniazid and Streptomycin were the most common polyresistant pattern identified. Meanwhile, 31.8% of MDR-TB patients resistance to all first-line anti-TB drugs. Majority of them were from Myanmar (57.7%, n = 116), primary TB cases (83.6%, n = 168), male (78.1%, n = 157), unemployed (36.8%, n = 74), and HIV negative (98.0%, n = 197). We observed no significant association between all the demographic and clinical history of the patients with their patterns of drug-resistant. Conclusion: Finding of this study may benefit the health practitioners in the screening of drug-resistant tuberculosis among foreign-born patients in Malaysia in the pursuit of combatting drug-resistant TB in the community.