Determinants of multi drug resistant tuberculosis among Tuberculosis patients in southwest ethiopia: unmatched Case control study

Abstract

Background: Multidrug-resistant tuberculosis (MDR-TB) is caused by Mycobacterium TB a bacterium that is resistant to at least isoniazid and rifampin. There are alarming reports of multidrug-resistant tuberculosis from different parts of the world, including Ethiopia. The multidrug-resistant TB in Ethiopia among new TB cases is estimated at 2.7 % and 14% in previously treated cases. However, Factors leading to development of drug resistance need to be understood to develop appropriate control strategies for national programs. Objectives: To identify determinants of multidrug-resistant tuberculosis (MDR-TB) among tuberculosis patients in southwest Ethiopia. Methods: Unmatched case-control study design was conducted used among 200 study population 134 controls and 65 cases from January13, 2021, to June 30, 2021 in southwest Ethiopia. Using systematic random sampling techniques for controls and for case purposive sampling was used. Data were collected using a structured questionnaire. Data were entered using Epi-Data version 3.4 and SPSS version 24 for analysis. Descriptive statistics was used. Binary logistic regression analyses were conducted to see the association between all explanatory variables and outcome variable and to identify candidate variables with p ≤ 0.20 for multivariable logistic regression model. Odds ratios along with 95%confidence interval (CI) were estimated to measure the strength of association .Level of Statistical significance was declared at p-value less than 0.05. Result: The response rate was 96.7% among cases and 100% among controls. Thirty one (47%) of cases and 63.3% of controls were males. Determinants of MDR TB were Social stigma [(AOR=5.2 95% CI:(1.69, 16.16)] , alcohol consumption [( AOR=4.1,95% CI:(1.04,15.80)], History of previous TB treatment [(AOR=5.3,95% CI:1.72,16.43)], a history of retreatment for TB [(AOR= 13.9,95%CI: (4.44, -40.04)], khat chewing [( AOR=6.2,95% CI:(1.91,20.63)] , Body mass index under nutrition (AOR=3.9 ,95% CI:(1.09,13.92)], and psychological illness [(AOR=9.4, 95% CI:( 1.76, 50.17)] and distance from treatment center <25km [(AOR=6.2 ,95% CI:2.00,19.04)] were identified as determinants of developing MDR-TB than their counterparts. Conclusion: stigma, Alcohol consumption, History of previous TB treatment, History of retreatment, Khat chewing, Body mass index, psychological illness and Distance from treatment center. Therefore better emphasis should be given to the national Prevention and control activities according to the contextual situations so that to avert the increasing problem from the country and moreover, to keep the health of the community