BACKGROUND: Multidrug-Resistant tuberculosis (MDR-TB) is a matter of worldwide concern. Identify associated risk factors may contribute to its control. OBJECTIVES: To assess if household tuberculosis (TB) cases would is a risk factor for MDR-TB. METHOD: A population-based case-control study was conducted in a retrospective way. Multidrug resistance was defined as resistance to at least Rifampin (RFM) and Isoniazid (INH), and susceptible TB (the case when first treatment had been made in a period similar to the first treatment of the MDR-TB cases, but disease free at the time of the interview). Selection of cases was made based upon the list of Susceptibility Tests (ST) carried out at the Central Laboratory of Public Health of the State of Ceará, from, 1990 to 1999. The proportion method was used. Controls were selected from among the records of the TB Control Program. The history of TB in the family was investigated. These cases were divided into three groups: cured TB, non adherence TB and MDR-TB. RESULTS: During the study period, 266 cases of MSR TB were diagnosed. We identified only 153 patients. Of these, 19 were excluded. The group of cases was comprised of 134 patients and that of controls by 185. Fisher exact test disclosed no association between MDR-TB and household contacts with TB cases (p=0.119). Studying the subgroups we found that contact with cured TB patients was associated with susceptible TB (p<0.0001) whereas household non-adherence TB and in the family MDR-TB were associated with MDR-TB, p<0.016 and p<0.03 respectively. CONCLUSION: In the family cases of MDR-TB and cases of nonadherence to treatment are risk factors for MDR-TB and therefore represent a public health problem.
Multidrug-resistant tuberculosis; Household contact; Non-adherence to tuberculosis treatment
