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Transbound Emerg Dis. 2019 Jul;66(4):1611-1618. doi: 10.1111/tbed.13188. Epub 2019 Apr 15.

Risk factors for multidrug-resistant tuberculosis in northwest Ethiopia: A case-control study.

Author information

1
School of Public Health, Curtin University, Bentley, WA, Australia.
2
Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia.
3
Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
4
Telethon Kids Institute, Perth, WA, Australia.
5
Department of Public Health Sciences, Centre for Global Health, Karolinska Institutet, Stockholm, Sweden.
6
Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.
7
School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Abstract

Ethiopia is one of 30-high burden multidrug-resistant tuberculosis (MDR-TB) countries globally. The aim of this study was to describe the characteristics of patients with MDR-TB and to investigate risk factors for MDR-TB relative to having drug-susceptible tuberculosis (TB), in northwest Ethiopia. A hospital-based, unmatched case-control study was conducted. Cases were all MDR-TB patients (i.e., resistant to at least rifampicin and isoniazid) who were confirmed by culture and drug-susceptibility testing whilst enrolled on treatment at Gondar University Hospital. Controls were all drug-susceptible tuberculosis (DS-TB) patients who were confirmed by Gene Xpert MTB/RIF at Gondar University Hospital. Univariable and multivariable logistic regression models were used for comparisons, and odds ratios with 95% confidence intervals (CI) were computed to measure the strength of association between the dependent and independent variables. A total of 452 patients (242 MDR-TB and 210 DS-TB) were included in this study. The mean age of the study participants was 33 years (SD ± 14 years). Approximately one-fifth (78, 17%) of all study participants were human immunodeficiency virus (HIV) positive; 21% (51) of cases and 13% (27) of controls. Risk factors associated with MDR-TB were a history of previous TB treatment (Adjusted Odds Ratio (AOR): 83.8; 95% CI: 40.7, 172.5), low educational status (AOR: 5.32; 95% CI: 1.43, 19.81); and ages less than 20 years (AOR: 9.01; 95% CI: 2.30, 35.25) and 21-30 years (AOR: 2.61; 95% CI: 1.02, 6.64). HIV infection was also significantly associated with MDR-TB among new TB patients (AOR: 5.55; 95% CI: 1.17, 26.20). This study shows that clinical and demographic features can be used to indicate higher risks of drug resistance in this setting.

KEYWORDS:

Ethiopia; MDR-TB; multidrug-resistant; tuberculosis

PMID:
30924283
DOI:
10.1111/tbed.13188
[Indexed for MEDLINE]

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