Determinants of multidrug resistant tuberculosis among adults undergoing treatment for tuberculosis in Tigray region, Ethiopia: A case-control study

Kidane Zereabruk1, Tensay Kahsay2, Hiyab Teklemichael2, Woldu Aberhe1, Abrha Hailay1, Guesh Mebrahtom1, Gebrewahd Bezabih2
1Department of Nursing, Aksum University, College of Health Sciences and Comprehensive Specialized Hospital, Aksum City, Tigray regional state, Ethiopia
2Department of Nursing, Mekelle University, College of Health Sciences and Comprehensive Specialized Hospital, Mekelle city, Tigray regional state, Ethiopia

ABSTRACT
Background: Multidrug-resistant tuberculosis is a type of tuberculosis that is resistant to at least the first-line anti-tuberculosis drugs namely, Rifampicin and Isoniazid. Multidrug-resistant tuberculosis has continued to be a challenge for tuberculosis control globally. Globally 600,000 people were newly eligible for multidrug-resistant tuberculosis treatment with an estimated 240,000 deaths annually. There is no published information regarding multidrug-resistant tuberculosis in the Tigray region. Therefore, the aim of this study was to assess the determinants of multidrug-resistant tuberculosis among adults undergoing treatment for tuberculosis in the Tigray region, Ethiopia.
Methods: Hospital-based unmatched case-control study was conducted from April to June 2019. A Simple random sampling method was used to select the required number of sample size. Primary data was collected from cases and controls by face-to-face interviews using pretested structured questionnaires. The binary logistic regression model was used to test the association between independent and dependent variables. Variables at p-value less than 0.25 in bivariate analysis were entered into a multivariable analysis to identify the determinant factors of multidrug-resistant tuberculosis. Finally, the level of significance was declared at a p-value <0.05.
Results: A total of 254 participants with 85 cases and 169 controls were included in this study. Rural residence [AOR=2.54; 95%CI=1.34-4.83], HIV [AOR=4.5; 95%CI=1.4-14.2], relapse [AOR=3.86; 95%CI; 1.98-7.5], return after lost follow up [AOR=6.29; 95% 1.64-24.2], treatment failure [AOR=5.87; CI=1.39-24.8] were among the determinants of multidrug resistance tuberculosis.
Conclusion: Rural residence, HIV, relapses, return after lost follow up and treatment failure were the identified determinant factors of multidrug-resistance tuberculosis.
Keywords: Determinants, Ethiopia, MDRTB, Tigray

Kidane Zereabruk MSc

Aksum University

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