Determinants of Multi-drug resistant Tuberculosis in four treatment centers of Eastern Amhara, Ethiopia: A case-control study.

Introduction: Tuberculosis is the major global burden of disease contributing about 2% of the global challenges. Poor tuberculosis treatment increased risk of multi-drug resistance tuberculosis occurence. Thus, we aimed to identify determinants of mult-drug resistant tuberclosis in treatment centers of Eastern Amhara, Ethiopia.

Methodology: Facility based unmatched case-control study was employed in East Amhara, Ethiopia. Cases were tuberculosis patients confirmed for mult-drug resistant tuberclosis while controls were tuberculosis patients with confirmed tuberculosis but susceptible to first line drugs. Respondents were selected using simple random sampling technique. Bivariable and multivariable analysis was conducted to identify diterminants at level of statistical significance p < 0.05.

Results: We enrolled 450 tuberculosis patients. Rural residents (AOR = 3, 95% CI: 1.4-6.0; p = 0.024), family size greater than five (AOR = 3.7, 95% CI: 1.6-8.6; p = 0.0098), having single room (AOR = 4.1, 95% CI:1.8-9.0; p = 0.027), room without window (AOR = 3.8, 95% CI: 1.6-8.5); p = 0.043), contact history of known mult-drug resistant tuberclosis patient (AOR = 5.1, 95% CI: 2.2-12.0; p = 0.02), history of tuberculosis treatment (AOR = 5.7, 95%CI: 2.6-12.9; p = 0.008), window opening practice (AOR = 3.7, 95% CI: 1.4-9.8; p = 0.005), tuberculosis treatment failure (AOR = 7.3, 95% CI: 5.2-7.8; p = 0.035) and tuberculosis relapse (AOR = 5,95% CI: 1.6-15.2; p = 0.019) were determinants of mult-drug resistant tuberclosis.

Conclusions: Socio-demographic (residence, family size), environmental (number of rooms, number of windows in a room, opening window practice) and clinical (history of tuberculosis treatment, treatment failure and having contact with known tuberculosis patient) variables were the identified determinants for increased multi-drug resistance tuberculosis.