Risk factors for multidrug-resistant tuberculosis in the Central African Republic: A case-control study

Abstract

Background: The emergence and spread of multidrug-resistant tuberculosis (MDR-TB) presents a challenge to the ''End TB by 2035'' strategy. This study aimed to identify the risk factors associated with MDR-TB in patients admitted to the pneumo-physiology clinic of the National University Hospital of Bangui in Central African Republic. Methods: This was a “retrospective” chart review study. Cases were represented by patients more than 18 years of age treated for MDR-TB and controls were patients with “at least rifampicin-susceptible” TB treated ''with first-line anti-TB regimen'' and who at the end of treatment were declared cured. The status of “cured” was exclusively applicable to non-MDR TB. Risk factors associated with MDR-TB were identified by multivariate analysis. Results: We included 70 cases and 140 controls. The median age was 35 years, IQR (22;46 years). The main factors associated with the occurrence of MDR-TB in multivariate analysis were male gender (0 R = 3.02 [1.89–3.99], p = 0.001), residence in a peri-urban/urban area (0 R = 3.06 [2.21–4.01], p = 0.002), history of previous TB treatment (0 R= 3.99 [2.77–4.25], p < 0.001) and the presence of multidrug-resistant TB in the family (0 R=1.86 [1.27–2.45], p = 0.021). Conclusion: The emergence of MDR-TB can be reduced by implementing appropriate strategies, such as preventive therapy in contacts of MDR-TB patients and detecting and appropriately treating MDR-TB patients to prevent further spread of infection.

Keywords

• Tuberculosis
• Multidrug-resistant tuberculosis
• Risk factors
• Bangui