Infection and Drug Resistance (Jun 2023)
Characteristics of TB/HIV Co-Infection and Patterns of Multidrug-Resistance Tuberculosis in the Northwest Amhara, Ethiopia
Abstract
Aynias Seid,1,2 Yilak Girma,3 Ayenesh Abebe,3 Eseye Dereb,3 Meseret Kassa,3 Nega Berhane2 1Department of Biology, College of Natural and Computational Science, Debre-Tabor University, Debre-Tabor, Ethiopia; 2Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia; 3TB Culture Laboratory, University of Gondar Comprehensive Specialized Hospital, Gondar, EthiopiaCorrespondence: Aynias Seid, Email [email protected]: Multidrug-resistant tuberculosis (MDR-TB) has continued to be a serious public health threat and significantly challenges global TB control and prevention efforts, where the TB/HIV co-infection epidemic makes the situation much worse. The aim of the study was to determine the determinant factors associated with patterns of MDR-TB among pulmonary TB patients in the Northwest Amhara, Ethiopia.Methods: A hospital-based cross-sectional study was conducted from May 2022 to February 2023 in the Northwest Amhara, Ethiopia. Data on the participants’ socio-demographics and clinical characteristics were obtained using a pre-tested checklist. Phenotypic susceptibility testing to first-line anti-TB drugs was performed on 180 isolates by automated BD BACTEC MGIT 960 system. Logistic regression analysis was performed to determine the association of risk factors with patterns of MDR-TB. A p-value ≤ 0.05 was considered statistically significant.Results: The overall proportion of TB with HIV co-infected cases was 19.8% (50/252). Culture positivity was confirmed in 203/252 (80.6%) of sputum samples. Among 168 isolates, the DST showed that 119 (70.8%) isolates were pan-susceptible to all first-line drugs and prevalence of any resistance to first-line drugs was 49,168 (29.2%). Among the resistant isolates, 28 (16.7%) were any mono-resistance and 12 (7.1%) were determined to be resistant to MDR-TB. TB with a previous TB treatment (aOR = 6.73, 95% CI: 1.78– 25.47, p = 0.005) and HIV co-infected (aOR = 0.252, 95% CI: 0.73– 0.875, p = 0.03) were significantly associated with MDR-TB.Conclusion: Higher prevalence of TB and MDR-TB was examined among TB patients in the study area. In the study, history of previous TB treatment was the strongest risk factor MDR-TB infection followed by TB with HIV co-infected cases. Therefore, there is a need of strengthening TB control and prevention programs to reduce the increase of TB incidence, further emergence and transmission of a public health threat of MDR-TB cases.Keywords: drug resistance, MDR-TB, prevalence, risk factors, TB/HIV co-infection