Prevalence and Associated Factors of Multidrug-Resistant Tuberculosis among Tuberculosis Patients at Yirgalem General Hospital, Sidama Regional State, Ethiopia: A Cross-Sectional Study Based on Five Years of Secondary Data

Abstract

Background: Drug-resistant tuberculosis (DR-TB) presents new barriers to the control of TB worldwide. It is a man-made problem,  largely as a consequence of human error in the quality of anti-TB drugs and patient treatment. Despite its importance, information is  scarce about MDR-TB to design effective and efficient recommendations for prevention and treatment strategies and policies in the study  area. 

Objective: This study aimed to assess the magnitude of MDR-TB and associated factors among tuberculosis patients at  Yirgalem General Hospital, Sidama Regional State, Ethiopia, from 2016 to 2020 

Methods: A hospital-based retrospective document review  was conducted at Yirgalem General Hospital. Data abstraction was done by trained data collectors using a standard abstract  sheet. Bi-variable and multi-variable logistic regressions were done to identify factors associated with the occurrence of MDR-MTB.  Variables with a p-value less than 0.25 in binary logistic regression were further fitted into multi-variable logistic regressions to control cofounders. In the final model, variables with a P-value <0.05 were considered statistically significant. The results were presented as Odds  ratio with 95% CI. 

Results: The prevalence of MDR-TB among TB-positive cases was 5.3% (95%CI, 3.8%, and 7.1%). Among MDR-TB  cases, 2.2% were newly treated cases, while 12.9% were previously treated cases. The trend of tuberculosis across the five years showed a  high proportion of MDR-TB cases in 2016 and 2017, with a declining trend in the last three consecutive years. Study participants who  had previous history of anti-TB treatment, 20-40 years and 41-60 year age groups, and patients who came from rural areas were more  likely to develop multi-drug resistant Mycobacterium tuberculosis. 

Conclusions: The prevalence of MDR-TB among TB-positive clients  was high. In addition, the trend of MDR-TB declined from 2016 to 2020. Factors like having a TB treatment history, advanced age, and  living in a rural area were factors linked with MDR-TB. Hence, monitoring and controlling mechanisms for correct and complete drug treatment should be enhanced. Stakeholders should provide special attention to the diagnosis, treatment, and prevention of MDR-TB  among rural and older TB patients.