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Modifiable and non-modifiable factors on previous tuberculosis treatment as a predisposition of multi drug resistance tuberculosis (mdr-tb): scoping review


Introduction: The increasing number of patients with resistant tuberculosis requires attention and efforts for prevention. Resistance causes more expensive cost of treatment, longer duration of treatment, more severe side effects and decreasing the chance of recovery. The specific purpose of this literature review was to identify modifiable and nonmodifiable factors associated with previous treatment as predisposing factors for MDR-TB.

Method: This study applies scoping review method of JBI (Joanna briggs Institute) by using 5 databases: Scopus, Ebscohost, Proquest, Science direct and google scholar publication 2015-2021. keywords for MDR-TB search, predisposing factors, previously treatment and adult.

Results: Modifiable factors related to previous tuberculosis treatment include treatment failure or discontinuation, non-adherence, lack of supervision, unclear or inadequate instructions. Meanwhile modifiable factors are side effects and relapse.

Conclusion: The cause of MDR-TB which can be modified and cannot be modified is very important to know. The government as a policy maker can use the results of this research to strengthen tuberculosis control programs and prevention of resistant tuberculosis


  1. Bhumiwat M. Factors Influencing the Prevalence of Multi-drug Resistant Tuberculosis in Thailand. 2017;(March).
  2. Desissa F, Workineh T, Beyene T. Risk factors for the occurrence of multidrug-resistant tuberculosis among patients undergoing multidrug-resistant tuberculosis treatment in East Shoa ,. 2018;1–7.
  3. Babure ZK, Bidu KT, Assefa JF, Weldemarium TD, Tufa AF. Risk Factors for Multi Drug-Resistant Tuberculosis Among Tuberculosis Patients of Nekemte Referral Hospotal, Oromia Regional State, Western Ethiopia, 2017. 2019;7(4):63–77.
  4. Zereabruk K. Determinants Of Multidrug Resistant Tuberculosis Among Adultsundergoing Treatment For Tuberculosis In Tigray Region , Ethiopia : A Case Control Study. 2020;1–20.
  5. Zhang C, Wang Y, Shi G, Han W, Zhao H, Zhang H. Determinants of multidrug-resistant tuberculosis in Henan province in China : a case control study. 2016;1–9.
  6. WHO. WHO Global report, 2016. Eur Respir J. 2016;44(1):23–63.
  7. Tembo BP. Prevalence and factors associated with multidrug / rifampicin resistant tuberculosis among suspected drug resistant tuberculosis patients in Botswana. 2019;7:1–9.
  8. Gobena D, Ameya G, Haile K, Abreha G, Worku Y, Debela T. Predictor of multidrug resistant tuberculosis in southwestern part of Ethiopia : a case control study. Ann Clin Microbiol Antimicrob [Internet]. 2018;1–8. Available from:
  9. Muchena G, Shambira G, Masuka N, Juru T, Gombe N, Takundwa L, et al. Determinants of multidrug resistance among previously treated tuberculosis patients in Zimbabwe, 2014. Int J Tuberc Lung Dis. 2017;21(11):1167–72.
  10. Wijayanto MA, Arnanda RA, Thamrin EP. Risk factors for development of multidrug-resistant tuberculosis among relapsed patients in west Papua, Indonesia: A descriptive and analytical study. Int J Appl Pharm. 2019;11(Special Issue 6):50–5.
  11. WHO. Global Tuberculosis Report 2017: Leave no one behind - Unite to end TB [Internet]. WHO - Technical Report Series;727. 2017. 146 p. Available from:
  12. WHO. WHO TB burden report 2018 [Internet]. Vol. 63, Workplace Health and Safety. 2018. 476 p. Available from:
  13. WHO. GLOBAL tuberculosis REPORT 2019. 2019.
  14. Shimeles E, Enquselassie F, Tilahun M, Mekonnen A, Wondimagegn G, Hailu T, et al. Risk Factors for Multidrug-Resistant Tuberculosis and Characteristics of Cases: A Case-Control Study of Patients Attending ALERT General Hospital in Addis Ababa, Ethiopia. Open J Respir Dis. 2019;09(01):1–17.
  15. Aznar ML, Rando-Segura A, Moreno MM, Soley ME, Igual ES, Bocanegra C, et al. Prevalence and risk factors of multidrug-resistant tuberculosis in Cubal, Angola: A prospective cohort study. Int J Tuberc Lung Dis. 2019;23(1):67–72.
  16. Elduma AH, Mansournia MA, Foroushani AR, Ali HMH, Elegail AMA, Elsony A, et al. Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study. Epidemiol Health. 2019;41:e2019014.
  17. Baya B, Achenbach CJ, Kone B, Toloba Y, Dabitao DK, Diarra B, et al. Clinical risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Mali. Int J Infect Dis [Internet]. 2019;81:149–55. Available from:
  18. Song WM, Li YF, Ma X Bin, Liu JY, Tao NN, Liu Y, et al. Primary drug resistance of mycobacterium tuberculosis in Shandong, China, 2004-2018. Respir Res. 2019;20(1):1–12.
  19. Alene KA, Viney K, McBryde ES, Gray DJ, Melku M, Clements ACA. Risk factors for multidrug-resistant tuberculosis in northwest Ethiopia: A case–control study. Transbound Emerg Dis. 2019;66(4):1611–8.
  20. Pradipta IS, Forsman LD, Bruchfeld J, Hak E, Alffenaar JW. Risk factors of multidrug-resistant tuberculosis: A global systematic review and meta-analysis [Internet]. Vol. 77, Journal of Infection. Elsevier Ltd; 2018. 469–478 p. Available from:
  21. Afshari M, Aarabi M, Parsaee M, Nezammahalleh A, Moosazadeh M. Determinant factors of drug resistant tuberculosis in Iran, a case control study. Clin Epidemiol Glob Heal [Internet]. 2019;7(3):322–4. Available from:
  22. Dlamini NC, Ji D Der, Chien LY. Factors associated with isoniazid resistant tuberculosis among human immunodeficiency virus positive patients in Swaziland: A case-control study. BMC Infect Dis. 2019;19(1):1–8.
  23. Ali MH, Alrasheedy AA, Hassali MA, Kibuule D, Godman B. Predictors of multidrug-resistant tuberculosis (MDR-TB) in Sudan. Antibiotics. 2019 Sep;8(3):90.
  24. Asgedom SW, Teweldemedhin M, Gebreyesus H. Prevalence of Multidrug-Resistant Tuberculosis and Associated Factors in Ethiopia: A Systematic Review. J Pathog. 2018;2018:1–8.
  25. Feng M, Xu Y, Zhang X, Qiu Q, Lei S, Li J, et al. Risk factors of multidrug ? resistant tuberculosis in China : A meta ? analysis. 2019;(December 2018):1–13.
  26. Stosic M, Vukovic D, Babic D, Antonijevic G, Foley KL, Vujcic I, et al. Risk factors for multidrug-resistant tuberculosis among tuberculosis patients in Serbia : a case-control study. 2018;1–9.
  27. Mesfin EA, Beyene D, Tesfaye A, Admasu A, Addise D, Amare M, et al. Drug-resistance patterns of mycobacterium tuberculosis strains and associated risk factors among multi drug-resistant tuberculosis suspected patients from Ethiopia. PLoS One. 2018;13(6):1–17.
  28. Okethwangu D, Birungi D, Biribawa C, Kwesiga B, Turyahabwe S, Ario AR, et al. Multidrug-resistant tuberculosis outbreak associated with poor treatment adherence and delayed treatment: Arua District, Uganda, 2013-2017. BMC Infect Dis. 2019;19(1):1–11.
  29. Mekonnen F, Tessema B, Moges F, Gelaw A, Eshetie S, Kumera G. Multidrug resistant tuberculosis: Prevalence and risk factors in districts of metema and west armachiho, Northwest Ethiopia. BMC Infect Dis. 2015;15(1):1–7.
  30. Ullah I, Javaid A, Tahir Z, Ullah O, Shah AA, Hasan F, et al. Pattern of drug resistance and risk factors associated with development of drug resistant mycobacterium tuberculosis in Pakistan. PLoS One. 2016;11(1):1–8.
  31. Rifat M, Hall J, Oldmeadow C, Husain A, Hinderaker SG, Milton AH. Factors related to previous tuberculosis treatment of patients with multidrugresistant tuberculosis in Bangladesh. BMJ Open. 2015;5(9):1–9.
  32. Mohd Shariff N, Shah SA, Kamaludin F. Previous treatment, sputum-smear nonconversion, and suburban living: The risk factors of multidrug-resistant tuberculosis among Malaysians. Int J Mycobacteriology [Internet]. 2016;5(1):51–8. Available from: RI 2015. fdokumen.com_buku-pedoman-nasional-pengendalian-tb-2015.pdf.
  33. D. Asefa, B. Seyoum, O Lemessa at all. Determinants of multidrug-resistant tuberculosis. 2017;209–14.
  34. Sharma P, Lalwani J, Pandey P, Thakur A. Factors associated with the development of secondary multidrug-resistant tuberculosis. Vol. 10, International Journal of Preventive Medicine. 2019. p. 67.
  35. Chuchottaworn C, Thanachartwet V, Sangsayunh P, Than TZM, Sahassananda D, Surabotsophon M, et al. Risk factors for multidrug-resistant tuberculosis among patients with pulmonary tuberculosis at the central chest institute of Thailand. PLoS One [Internet]. 2015;10(10):1–18. Available from:
  36. Dzeyie KA, Basu S, Dikid T, Bhatnagar AK, Chauhan LS, Narain JP. Epidemiological and behavioural correlates of drug-resistant tuberculosis in a Tertiary Care Centre, Delhi, India. Indian J Tuberc [Internet]. 2019;66(3):331–6. Available from:
  37. Gaborit BJ, Revest M, Roblot F, Maakaroun-Vermesse Z, Bemer P, Guimard T, et al. Characteristics and outcome of multidrug-resistant tuberculosis in a low-incidence area. Med Mal Infect [Internet]. 2018;48(7):457–64. Available from:
  38. Hameed S, Ahmad SR, Rahman MA ur, Nazir H, Ullah I. Drug resistance profile of Mycobacterium tuberculosis and predictors associated with the development of drug resistance. J Glob Antimicrob Resist [Internet]. 2019;18:155–9. Available from:
  39. Dessalegn M, Daniel E, Behailu S, Wagnew M, Nyagero J. Predictors of multidrug resistant tuberculosis among adult patients at Saint Peter Hospital Addis Ababa, Ethiopia. Pan Afr Med J. 2016;25(Supp 2):5.
  40. Fregona G, Cosme LB, Moreira CMM, Bussular JL, Dettoni V do V, Dalcolmo MP, et al. Risk factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. Rev Saude Publica. 2017;51:41.
  41. Workicho A, Wondwosen K, Fassahaye A. Risk factors for multidrug-resistant tuberculosis among tuberculosis patients: a case-control study. BMC Public Health. 2017;18(1):91–6.
  42. Fambirai T. Factors Associated With Occurrence of Multi Drug Resistant Tuberculosis in Harare City, 2015. 2015;(August). Available from:
  43. Huai P, Huang X, Cheng J, Zhang C, Wang K, Wang X, Yang L, Deng Z, Ma W. Proportions and Risk Factors of Developing Multidrug Resistance Among Patients with Tuberculosis in China: A Population-Based Case–Control Study. Microbial Drug Resistance. 2016 Dec 1;22(8):717-26.
  44. Kemenkes RI 2015. fdokumen.com_buku-pedoman-nasional-pengendalian-tb-2015.pdf.
  45. Demile B, Zenebu A, Shewaye H, Xia S, Guadie A. Risk factors associated with multidrug- resistant tuberculosis ( MDR-TB ) in a tertiary armed force referral and teaching hospital ,. 2018;1–11.
  46. Nellums LB, Rustage K, Hargreaves S, Friedland JS. Multidrug-resistant tuberculosis treatment adherence in migrants: A systematic review and meta-analysis. BMC Med. 2018;16(1):1–12.
  47. Kemenkes RI. Buku Saku Pasien TB MDR. 2015:1–35.
  48. Liu YX, Pang CK, Liu Y, Sun X Bin, Li XX, Jiang SW, et al. Association between multidrug-resistant tuberculosis and risk factors in china: Applying partial least squares path modeling. PLoS One. 2015;10(5):1–14.
  49. Arora G, Sajid A, Kalia VC. Drug resistance in bacteria, fungi, malaria, and cancer. Drug Resist Bact Fungi, Malaria, Cancer. 2017;1–629.
  50. Aggarwal A, Mehta S, Gupta D, Sheikh S, Pallagatti S, Singh R, et al. Extensively drug-resistant tuberculosis in India: Current evidence on diagnosis & management. J Dent Educ [Internet]. 2012;76(11):1532–9. Available from:
  51. Baya B, Achenbach CJ, Kone B, Toloba Y, Dabitao DK, Diarra B, et al. Clinical risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Mali. Int J Infect Dis [Internet]. 2019;81:149–55. Available from:
  52. Deshmukh RD, Dhande DJ, Sachdeva KS, Sreenivas AN, Kumar AMV, Parmar M. Social support a key factor for adherence to multidrug-resistant tuberculosis treatment. Indian J Tuberc [Internet]. 2018;65(1):41–7. Available from:
  53. Tembo BP, Malangu NG. Prevalence and factors associated with multidrug/rifampicin resistant tuberculosis among suspected drug resistant tuberculosis patients in Botswana. BMC Infect Dis. 2019;19(1):1–8.
  54. Inriati R. Anti-Tuberculosis. Curr Bioact Compd. 2016;2(1):105–105.

How to Cite

Puasa, M., & Chayati, N. (2021). Modifiable and non-modifiable factors on previous tuberculosis treatment as a predisposition of multi drug resistance tuberculosis (mdr-tb): scoping review. Bali Medical Journal, 10(3), 1294–1303.




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