Predictor of multidrug resistant tuberculosis in southwestern part of Ethiopia: a case control study

Abstract

BackgroundCurable disease tuberculosis is becoming incurable or difficult to treat due to drug resistance. Multi drug resistance tuberculosis is a major health problem for less developed countries. Development of drug resistance is mainly as result of man related factors and poor lifestyle. Identifying predictors of drug resistance and working on them is the important way of reducing the expansion in high burden countries. Ethiopia is one of TB, TB/HIV, and multi-drug resistant tuberculosis (MDR-TB) high burden country globally. This study was aimed to assess predictor of MDR-TB in southwest part of Ethiopia.MethodsUnmatched case control study was conducted in case to control ratio of 1:1.2 in southwest part of Ethiopia. The cases were recruited from confirmed MDR-TB patient enrolled on second line treatment in Shenen Gibe Hospital (MDR-TB treatment center of the prefecture) and the controls were recruited from previously TB patients who cured or patient with smear negative at the end of treatment month during the study period in the same area. The data was collected by structured questionnaire by interview and logistic regression analyses were used to identify predictors of MDR-TB. Odds ratios with 95% CI were computed to determine the predictors.ResultFrom the total 132 participants about 45% of them were cases. None disclosed tuberculosis infected to relatives [AOR = 3.4, 95% CI (1.2–9.8)], insufficient instruction on how to take anti-TB drug [AOR = 4.7, 95% CI (1.4–14.6)], contact history with MDR-TB [AOR = 8.5, 95% CI (2.9–25.5)], interruption of first-line anti-TB treatment for at list 1 day [AOR = 7.9, 95% CI (2.5–24.9)], and having alcohol drinking habits [AOR = 5.1, 95% CI (1.4–18.7)] were identified predictors for MDR-TB infection in study area.ConclusionTB infection disclosure status, insufficient instruction on drug usage, contact history with MDR-TB, interruption of first-line anti-TB drugs, and alcohol drinking habits were identified predictor of MDR-TB case. Therefore, early detection and proper treatment of drug susceptible TB, strengthening directly observed treatment, short-course on daily bases, community involvement, and supporting the patient to intervene identified factors is paramount.

WITHDRAWN: Determinants Of Multidrug Resistant Tuberculosis Among Adultsundergoing Treatment For Tuberculosis In Tigray Region, Ethiopia: A Case Control Study

“…There are limited numbers of MDR-TB studies in different regions of Ethiopia [19,20,21]. Therefore, the main aim of this study was to identify the determinant factors MDR TB among adults undergoing treatment for tuberculosis in Tigray region, Ethiopia.…”

Determinants of Multi-Drug Resistant Tuberculosis Among Patients Attending Anti-Tuberculosis Treatment From Peripheral Districts, Southern Ethiopia, 2019: a Case Control Study

“…This was in line with the study that was conducted in East Shoa (11). However, MDR-TB was not associated with residence according to the studies that were conducted in Jimma (13), China (26) and Iran (27). This difference might be due to access of TB services nearby and low knowledge of TB for drug adherence, transportation problem, inadequate social support and fear of stigma to complete anti-TB drugs.…”

“…In contrast, Addis Ababa(10) greater than secondary had a signi cant association with MDR-TB. However, the studies in East Shoa (11) and Jimma (13),being uneducated were not associated with occurrence of MDR-TB, in Serbia (25); a level of education did not affect development of MDR-TB. This may be due to this study recruited the participants from peripheral districts and majority of the respondents were rural dwellers that might have a poor access for education and health literacy.…”

“…Data were collected by using pre-tested and structured questionnaire. Data collection tool was adopted from previous studies (10,11,13,(20)(21)(22)(23).…”

“…Immune-compromising conditions ( HIV, under nutrition, smoking, and drug and alcohol abuse), history of previous treatment, contact history, body mass index below 18.5 Kg/m 2 , diabetes mellitus, chronic obstructive pulmonary diseases, smear positivity, history of hospitalization, stigma, history of imprisonment and being refugee camp were the risk factors for MDR-TB (1,(10)(11)(12)(13)(14).…”