Epidemiological Trends and Multidrug-Resistant Tuberculosis Burden in Vikarabad District: A Cross-Sectional Observational Study.

Background: Multidrug-resistant tuberculosis (MDR-TB) remains a public health concern, particularly in resource-constrained settings. Limited data exist on the regional burden and epidemiological patterns of MDR-TB in Vikarabad district, Telangana, India. This study was conducted to evaluate the clinical characteristics, prevalence of drug resistance, and treatment outcomes among patients diagnosed with tuberculosis. Methods: A cross-sectional observational study was conducted from October 2023 to January 2025 across DOTS centers in Vikarabad district. A total of 300 bacteriologically confirmed TB patients were enrolled. Demographic and clinical data were collected using structured case records. Drug susceptibility testing (DST) for rifampicin and isoniazid was performed using GeneXpert and line probe assays. Treatment outcomes were evaluated per national TB program guidelines. Results: The mean age of participants was 38.4 ± 14.7 years, with 66% being male and 59% residing in rural areas. Pulmonary TB accounted for 81% of cases. Of the total sample, 24% were previously treated TB cases. Rifampicin resistance was detected in 6% of participants; MDR-TB was confirmed in 4%. Notably, 13.9% of previously treated cases were MDR-TB, compared to 0.9% in new cases. Treatment success was achieved in 80% of patients overall, but only 58.3% among MDR-TB cases. Drug-sensitive TB patients had a significantly higher success rate of 82.2%. Conclusion: MDR-TB remains a considerable burden in Vikarabad, particularly among previously treated TB cases. Targeted DST, robust follow-up, and community-based adherence strategies are essential to improve outcomes and reduce transmission. Recommendations: Enhance early DST access, strengthen treatment adherence monitoring, integrate TB counseling at primary care, and ensure continuous drug supply and follow-up systems to effectively manage MDR-TB in high-risk rural populations.