The findings from the sixth national Prevalence Drug-Resistant Tuberculosis Survey in Nepal, 2024

The findings from the sixth national Prevalence Drug-Resistant Tuberculosis Survey in Nepal, 2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The findings from the sixth national Prevalence Drug-Resistant Tuberculosis Survey in Nepal, 2024 Naveen Prakash Shah, Bhuwan Poudel, Prajowl Shrestha, Lok Raj Joshi, and 12 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8759187/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 16 You are reading this latest preprint version Abstract Introduction: Tuberculosis remains a major public health challenge in Nepal, with rising drug-resistant TB and limited surveillance capacity. To address this gap, we conducted the sixth national drug-resistant TB prevalence survey to estimate DR-TB burden and risk factors among new and previously treated pulmonary TB patients. Methods: We conducted a national cross-sectional survey from December 2022 to January 2024, enrolling bacteriologically confirmed pulmonary TB patients using stratified cluster sampling from 49 diagnostic centers. Phenotypic and genotypic DST was performed on 1,768 Mycobacterium tuberculosis–confirmed samples, and logistic regression was used to estimate DR-TB prevalence and associated risk factors. Results: Rifampicin resistance was 2.2% (95% CI: 1.4–3.6) among new TB patients and 10.1% (95% CI: 5.1–19) among previously treated patients. Overall, 9.4% had resistance to at least one first-line drug, with isoniazid showing the highest resistance. Fluoroquinolone resistance was higher among new RR-TB patients, and previous TB treatment was the strongest predictor of rifampicin resistance (aOR: 4.1; 95% CI: 2.6–6.4). Conclusion: Nepal’s RR/MDR-TB prevalence remains stable compared with previous surveys; however, high fluoroquinolone resistance among new patients underscores the need for improved antibiotic stewardship and expanded DST services. These findings provide essential evidence to inform national TB control strategies. Rifampicin Resistance multidrug-resistant risk factors Antimicrobial Stewardship TB treatment Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 17 Mar, 2026 Reviews received at journal 14 Mar, 2026 Reviews received at journal 09 Mar, 2026 Reviewers agreed at journal 02 Mar, 2026 Reviewers agreed at journal 26 Feb, 2026 Reviews received at journal 25 Feb, 2026 Reviewers agreed at journal 25 Feb, 2026 Reviewers agreed at journal 25 Feb, 2026 Reviewers agreed at journal 25 Feb, 2026 Reviews received at journal 15 Feb, 2026 Reviewers agreed at journal 07 Feb, 2026 Reviewers agreed at journal 06 Feb, 2026 Reviewers invited by journal 06 Feb, 2026 Editor assigned by journal 02 Feb, 2026 Submission checks completed at journal 02 Feb, 2026 First submitted to journal 01 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8759187","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":587363507,"identity":"5ca18fa9-f0b4-4217-93ee-9189ea9714ce","order_by":0,"name":"Naveen Prakash 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