Determinants of Multi-Drug-Resistant Tuberculosis among Tuberculosis Patients in Jimma Zone Southwest Ethiopia, 2025: A Case-Control Study

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.