Evidence map›Paper›PMID 39512908›Full record

ArticleIJID regions2024

High incidence of multidrug-resistant tuberculosis in Bhutan: A cohort study based on national TB surveillance data.

Thinley Dorji, Karchung Tshering, Lila Adhikari, Thinley Jamtsho, Pavitra Bhujel, Pema Lhaden, Norelle L Sherry, Chantel Lin, Kristy Horan, Sonam Wangchuk and 2 more

Abstract read
In one paragraph

Article in IJID regions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Extensive Endemic Transmission of Multidrug-ResistantOpen forum infectious diseases · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Thinley DorjiKanglung Hospital, Trashigang, Bhutan.
Karchung TsheringNational Tuberculosis Reference Laboratory, Royal Centre for Disease Control (Ministry of Health), Serbithang, Thimphu, Bhutan.
Lila AdhikariNational Tuberculosis Reference Laboratory, Royal Centre for Disease Control (Ministry of Health), Serbithang, Thimphu, Bhutan.
Thinley JamtshoRoyal Centre for Disease Control (Ministry of Health), Serbithang, Thimphu, Bhutan.
Pavitra BhujelNational Tuberculosis Reference Laboratory, Royal Centre for Disease Control (Ministry of Health), Serbithang, Thimphu, Bhutan.
Pema LhadenNational Tuberculosis Reference Laboratory, Royal Centre for Disease Control (Ministry of Health), Serbithang, Thimphu, Bhutan.
Norelle L SherryDepartment of Microbiology and Immunology at The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
Chantel LinDepartment of Microbiology and Immunology at The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
Kristy HoranDepartment of Microbiology and Immunology at The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
Sonam WangchukRoyal Centre for Disease Control (Ministry of Health), Serbithang, Thimphu, Bhutan.
Patiyan AnderssonDepartment of Microbiology and Immunology at The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
Benjamin P HowdenDepartment of Microbiology and Immunology at The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: The emergence of multidrug-resistant tuberculosis (MDR-TB) has made the elimination of TB difficult. Currently, there are limited data on MDR-TB and other drug-resistant TB in Bhutan. We aimed to estimate the incidence and explore the potential risk factors associated with MDR/pre-extensively drug-resistant (pre-XDR)-TB using comprehensive national TB data. Methods: We used the data from the Tuberculosis Information Surveillance System of the National Tuberculosis Reference Laboratory to analyze the resistance pattern and epidemiologic data for all TB cases tested for resistance for the year 2018-2021. Multiple logistic regression was performed to identify risk factors associated with MDR/pre-XDR-TB. Results: Of the 2,290 samples tested for drug resistance, 10.6% (n = 243) was MDR-TB, 3.5% (n = 81) was isoniazid-resistant TB, and 0.61% (n = 14) was pre-XDR-TB. A high incidence of MDR/RR-TB/pre-XDR-TB was documented among patients in Thimphu, Samtse, and Sarpang districts. MDR/pre-XDR-TB was more likely documented among patients aged 18-39 years (adjusted odds ratio [aOR] 2.79; 95% confidence interval [CI] 1.46-6.07), female sex (aOR 1.37; 95% CI 1.01-1.86), and patients previously treated for TB (aOR 2.98; 95% CI 1.99-4.42). Conclusions: Given the high burden of MDR-TB in some districts, decentralization of diagnostic facilities for more rapid characterization could improve early recognition of drug-resistant cases and assist in management. Comprehensive follow-up and monitoring of high-risk groups should be performed.

Indexed as

BhutanHigh TB burdenMDR-TBMycobacterium tuberculosisRisk factorsTB

Identifiers

PMID39512908
PMCPMC11541819

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.