Determinants of Multi-Drug Resistant Tuberculosis among Tuberculosis Patients in Southern Ethiopia: A Case Control Study

Multi-drug resistance tuberculosis (MDR) have been a hazardous concern both in developed and developing countries. Little information is available regarding the determinants of MDR-TB in Ethiopia, and hence, We assessed the probable determinants of MDR-TB in Southern Ethiopia. A case-control study was conducted. Cases were TB patients with simultaneous resistance to at least rifampicin (RMP) and isoniazid (INH) and controls were TB patients who were susceptible to first line TB drugs and registered as cure or treatment completed from March 2016 to March 2018. We used simple random sampling method to select cases and controls. Data were collected using semi-structured questionnaire with face to face interview and patients’ clinical record review. Bivariate and multivariate logistic regression analysis was done to determine determinants of MDR-TB. Significance level was adjusted at p-value <0.05. A total 102 cases together with 102 controls participated in the study. The mean age for cases and controls were 35.6 years (SD± 13.6) and 31.2 years (SD ±15.4) respectively. Factors that independently predicted MDR-TB were: time to reach health facility taking more than three hours (AOR 2, 95%CI=0.10-0.45), history of contact with known MDR-TB patients (AOR 6, 95%CI=1.8-19.7), patients with no formal education (AOR 4.40, 95%CI=1.7-13.3), patients who didn’t get counseling (AOR 5, 95% CI=1.8-14) and patients who didn’t hear about MDR-TB (AOR 6.8, 95% CI=2.99-15.3). Multiple factors predicted MDR-TB. Patients: at distant location, with known contact history of MDR-TB patients, with low level of literacy, who lack information on MDR-TB and who didn’t get counseling deserve special attention.