Abstract:
Background: Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains the
leading infectious killer globally, with an estimated 10.6 million new cases and 1.25 million
deaths annually. Despite progress in TB control, Multi-drug-resistant tuberculosis (MDR-TB)
remains a major global public health challenge.However; there is limited evidence on the
determinants of MDR-TB in the study area.
Objective: To identify the determinants of multi-drug-resistant tuberculosis (MDR-TB)
among tuberculosis patients in Jimma Zone, Southwest Ethiopia, 2025
Methods: A facility-based unmatched case-control study was conducted among TB patients
attending Shenen Gibe and Limu Genet General Hospitals from March to May, 2025. A total
of 64 cases and 128 controls were selected using a simple random sampling method. Cases
were MDR TB patients, while controls were Drug susceptible TB patients. Data were
collected through a structured questionnaire using Kobo Toolbox and review of clinical
records, then analyzed using SPSS version 27. Bivariable and multivariable binary logistic
regression analyses were performed to identify determinants of MDR-TB. Adjusted odds
ratios (AORs) with 95% confidence intervals (CIs) were reported, with statistical significance
set at p < 0.05.
Results: A total of 192 participants (64 cases and 128 controls) were included in this study
with 100% response rate. Among the participants, 33 (51.6%) of the cases and 57 (44.5%) of
the controls were males. Daily laborers (AOR = 8.50; 95% CI: 3.10–24.38), rural residence
(AOR = 3.93; 95% CI: 1.45–10.63), history of contact with TB patients (AOR = 7.99; 95%
CI: 2.80–22.80), history of drug interruption (AOR = 4.36; 95% CI: 1.41–13.50), history of
previous TB treatment (AOR = 3.20; 95% CI: 1.16–8.89), and being underweight (AOR =
2.66; 95% CI: 1.02–6.90) were found to be determinants of MDR-TB.
Conclusion: MDR-TB was significantly associated with sociodemographic, clinical, and
behavioral factors. Targeted interventions focusing on daily laborers, rural residents, patients
with a history of TB contact or drug interruption, history of previous TB treatment and
underweight individuals are essential to reduce the burden of drug-resistant TB in the region.
