The main risk factors for MDR-TB are social determinants of health

Factors associated with primary transmission of multidrug-resistant tuberculosis compared with healthy controls in Henan Province, China
Wei-Bin Li, Yan-Qiu Zhang, Jin Xing, Zhen-Ya Ma, Ya-Hong Qu and Xin-Xu Li, Infectious Diseases of Poverty 2015, 4:14

Findings from this study showed that being single, earning a low income, having mental stress, lacking medical insurance, and suffering from a chronic debilitating disease were potential risk factors associated with primary MDR-TB. However, risk factors of nosocomial transmission and close contact were not found.

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Community based interventions for the prevention and control of tuberculosis

Infectious Diseases of Poverty is an open access peer-reviewed journal publishing articles around essential public health questions relating to infectious diseases of poverty.


In 2012, an estimated 8.6 million people developed tuberculosis (TB) and 1.3 million died from the disease. With its recent resurgence with the human immunodeficiency virus (HIV); TB prevention and management has become further challenging. We systematically evaluated the effectiveness of community based interventions (CBI) for the prevention and treatment of TB and a total of 41 studies were identified for inclusion. Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates (RR: 3.1, 95% CI: 2.92, 3.28) with non-significant impact on TB incidence. CBI for treating patients with active TB showed an overall improvement in treatment success rates (RR: 1.09, 95% CI: 1.07, 1.11) and evidence from a single study suggests significant reduction in relapse rate (RR: 0.26, 95% CI: 0.18, 0.39). The results were consistent for various study design and delivery mechanism. Qualitative synthesis suggests that community based TB treatment delivery through community health workers (CHW) not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems. CBI coupled with the DOTS strategy seem to be an effective approach, however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.

Keywords: Community-based interventions; Tuberculosis; DOTS; integrated delivery; CHWs