Infection and Drug Resistance (Jul 2022)
Determinants of Multidrug-Resistant Mycobacterium tuberculosis Infection: A Multicenter Study from Southern Ethiopia
Abstract
Abdulkerim Badgeba,1 Mulugeta Shegaze Shimbre,2 Mathewos Alemu Gebremichael,3 Biruk Bogale,4 Menur Berhanu,5 Hanan Abdulkadir6 1Department of Public Health, College of Medicine and Health Sciences, Werabe University, Werabe, Ethiopia; 2School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; 3Department of Public Health, College of Health Sciences, Bonga University, Bonga, Ethiopia; 4School of Public Health, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Aman, Ethiopia; 5Ohio State University Global One-Health Initiatives, Arba Minch, Ethiopia; 6Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Mathewos Alemu Gebremichael; Biruk Bogale, Email [email protected]; [email protected]: Multidrug-resistant tuberculosis (MDR-TB) continues to be a public health problem. Globally in 2019, a total of 465,000 people developed rifampicin-resistant TB (RR-TB), of which 78% had MDR-TB. There is a paucity of evidence on the determinants of MDR-TB in southern Ethiopia. Hence, this study aimed to assess the determinants of MDR-TB in southern Ethiopia.Methods: A hospital-based case–control study was conducted in southern Ethiopia. The cases were all MDR-TB patients attending TB clinics, and controls were all patients who were declared as cured or treatment completed. The cases were selected by consecutive sampling, and a simple random sampling technique was used for controls. Multivariable logistic regression analysis was done to identify determinants of MDR-TB. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed, and statistical significance was declared at a P-value less than 5%.Results: A total of 191 participants, 67 cases, and 124 controls were included. TB patients facing social stigma (AOR = 8.9, 95% CI: 2.3– 34.6), living in a household with one room (AOR = 12.3, 95% CI: 2.3– 63.5), and two rooms (AOR = 9.7, 95% CI: 1.7– 54.8), having the previous history of TB treatment (AOR = 11.8, 95% CI: 2.9– 47), having baseline body mass index (BMI) less than 18.5Kg/m2(AOR = 4.5, 95% CI: 1.2– 16.8), and having pulmonary TB (AOR = 5.1, 95% CI: 1.33– 19.8) were determinants of MDR-TB.Conclusion: In this study, TB patients facing social stigma, living in one- and two-roomed houses, having a previous history of TB treatment, having low baseline BMI and pulmonary type of TB had higher odds of MDR-TB. Therefore, health workers in TB control programs should include mental health services in the TB care protocol, and priority should be given to malnutrition screening as a first-line diagnosis, nutritional supplements, and health education about proper housing.Keywords: multidrug-resistant tuberculosis, determinants, case-control, southern Ethiopia
