Risk factors for the occurrence of multidrug-resistant tuberculosis among patients undergoing multidrug-resistant tuberculosis treatment in East Shoa, Ethiopia

Abstract

BackgroundMultidrug-resistant tuberculosis (MDR-TB) is resistant to the two main first-line anti-tuberculosis drugs: rifampicin and isoniazid. It is a major threat to public health worldwide. The objective of this study was to assess the potential risk factors for multidrug-resistant tuberculosis among patients undergoing MDR-TB treatment at two community hospitals in Ethiopia.MethodsA case-control study design was conducted from February 1, 2016, to April 29, 2016. TB-positive patients with MDR-TB and non-MDR-TB were considered as cases and controls, respectively. A total of 219 study participants were included in the study. An interviewer-administered structured questionnaire was used to collect primary data from the patients, and a checklist was used to collect data from the clinical records. Bivariate and multivariate logistic regression analyses were used to assess the potential risk factors for the occurrence of MDR-TB.ResultsThe odds of developing MDR-TB were higher in patients previously treated with anti-TB drugs (odds ratio [OR] = 6.1, 95%CI: 2.92–12.62, P < 0.001), those with a history of contact with known TB patients (OR = 2.1, 95%CI: 1.04–4.43, P < 0.001), those living in a rural setting (OR = 5.6, 95%CI: 2.14–14.46, P = 0.001), those with a history of alcohol consumption (OR = 4.3, 95%CI: 2.29–10.49, P < 0.001) and those without a job (OR = 2.4, 95%CI: 1.06–5.42, P = 0.001).ConclusionsThe study revealed that contact with known TB patients, previous TB treatment, residence area, lack of a job, and alcohol consumption were potential risk factors for the occurrence of MDR-TB. Enhancing public health education, intensifying directly observed therapy programmes for all TB patients and designing control strategies are recommended.

WITHDRAWN: Determinants Of Multidrug Resistant Tuberculosis Among Adultsundergoing Treatment For Tuberculosis In Tigray Region, Ethiopia: A Case Control Study

“…MDR-TB was significantly associated with residence area; living in a rural area increased the occurrence of MDR-TB compared with living in an urban area. This is similar to the studies conducted in east Shoa, Oromia region and Amhara regional state, Ethiopia [23,24,25]. This could be due to the huge proportion of people living rural area, difference in access to TB services, socio-economy and the level of knowledge about adherence to first-line anti TB treatment, as rural communities have poor adherence to treatment that likely leads to the MDR-TB [23].In contrast, a study conducted in southwestern Ethiopia showed that rural residence was not associated with the development of MDR TB [22].…”

“…This might be due to drug mal-absorption in HIV infected patients since the patient is taking both ART medication and anti TB medications, especially ethambutol and rifampicin can lead to drug-resistance and treatment failure [26]. In contrast, HIV was not associated with the occurrence of MDR-TB in a study conducted in southwestern and, east Shoa, Ethiopia [22,23]. This discrepancy might be due to the sample size difference.…”

“…AOR=2.4, 95% CI=95%, Power= 80%, percent controls exposed=16.9, and percent of cases exposed for cases was taken 32.8 from a study conducted in eastern Shoa, Ethiopia [21].…”

“…Data quality was ensured by giving two days of training for data collectors and supervisors and by providing supervision during the data collection period. First, the questioner was adapted from a published paper in English form [21], then translated into Tigrigna (local language) and backtranslated into English to ensure its consistency. Each questionnaire was checked for completeness before leaving the study area.…”

“…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.…”