ZalalemKaba Babure1*,KassahunTegegne Bidu2, FekaduAssefa Jiru3, TesfayeDagne Weldemarium4,and AkliluFikadu Tufa5.
1Quality officer at East Wollega Zonal Health Office, Nekemte, Oromia, Western Ethiopia,
2Program Officer at USAID/JSI Transform: Primary HealthCare Project, East Wollega Zone, Nekemte, Western Ethiopia
3High Quality Clinical Care Technical Advisor Oromia Regional Health Bureau, Addis Ababa, Ethiopia
4Department of health economics, management and policy, College of Health Sciences, Jimma University
5Program Officer at USAID/JSI Transform: Primary HealthCare Project, East Wollega Zone, Nekemte, Western Ethiopia

Scientific Research and Reviews

Multidrug-Resistance Tuberculosis (MDR-TB) is tuberculosis (TB) that is resistant to two first-line drugs; both isoniazid and rifampicin. Globally in 2015, there were an estimated 480, 000 new cases of multidrug-resistant TB. According to the anti-tuberculosis drug resistance survey conducted nationwide in Ethiopia in 2012 among 804 newly diagnosed TB cases 1.6 % were found to be infected with MDR-TB. The continuous challenge in the occurrence and management of Multidrug-Resistant Tuberculosis (MDR-TB) in the country in general and Nekemte Referral hospital in particular prompted this study which seeks-to investigate the risk factors for MDR-TB.Unmatched case control study design was conducted to identify the risk factors for multi-drug resistant tuberculosis among tuberculosis patients of Nekemte Referral Hospital. All MDR-TB (21 cases) and Non-MDR-TB (44 controls) patients’ registered from September 2016to August 2017 in this Hospital were included in the study. Face-to-face interview and Patient medical records review were used to collect the data. In bivariate analysis; variables which had P-value <=0.25 wereentered into multi-variate logistic regression model. P-value <0.05 taken as statistically significant. A total of 65 tuberculosis patients (21 cases and 44 controls) included in this study; response rate 100 %. Previous tuberculosis treatment (AOR = 0.975, 95 % CI = 0.957 – 0.994), history of defaulter (AOR=0.055, 95 % CI=0.008-0.391), history of Smoking (AOR=74.833, 95 % CI=1.563-36.248), number of rooms in the house (AOR=5.410,95 % CI=1.579-18.536) and presence of HIV/infection (AOR=0.232,95 % CI=0.065-0.823) were statistically significant predictors of having multidrug-resistance tuberculosis.History of- previous tuberculosis treatment; defaulter and smoking, number of rooms in the house, and presence of human immune virus infection were significant predictors in this study.Health education on adherence to anti-tuberculosis drugs and risky behaviorshould be given a special attention.

Keywords: Multidrug-resistant, Tuberculosis, Nekemte, Risk factor, Case-control.

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ZalalemKaba Babure,KassahunTegegne Bidu, FekaduAssefa Jiru, TesfayeDagne Weldemarium,and AkliluFikadu Tufa.RISK FACTORS FOR MULTI DRUG-RESISTANT TUBERCULOSIS AMONG TUBERCULOSIS PATIENTS OF NEKEMTE REFERRAL HOSPITAL, OROMIA REGIONAL STATE, WESTERN ETHIOPIA, 2017. .Scientific Research and Reviews, 2019, 12:102


1. A survival guide for clinicians, Epidemiology and Background of drug-resistant tuberculosis (June 2016). http://www.currytbcenter.ucsf.edu/sites/default/files/tb_sg3_book.pdf.
2. Abate G, Miorner H (1998). Susceptibility of MDR strains of M.tuberculosis to amoxicillin in combination with clavulanic acid and ethambutol. J AntimicobChemother, 42:735–740.
3. Abdulhalik W, Wondwosen K, Fessahaye A (13 March 2017). Risk factors for multidrug-resistant tuberculosis among tuberculosis patients: a case-control study, Infection and Drug Resistance:10.
4. Agonafir M, Lemma E, Wolde-Meskel D, Goshu S, Santhanam A (2010). Phenotypic and genotypic analysis of multidrug-resistant tuberculosis in Ethiopia. Int J Tuberc Lung Dis;14(10):1259–1265.
5. Ahsan MA, Saeed A, Rumina H, Javaid AK, Syed FH, Nadeem R (2012). Risk factors for multidrug-resistant tuberculosis in urban Pakistan: A multicenter case–control study. International Journal of Mycobacteriology,1:137-142.
6. Alena S,HenadzH,AksanaZ,EvgeniS,AndreiA,SvenH,et.al(2013). Multidrug-resistant tuberculosis in Belarus: the size of the problem and associated risk factors. Bull World Health Organ; 91:36–45. Doi:10.2471/BLT.12.104588.
7. Clinical Practice Guidelines (CPG, December 2016). Management of DR-TB (First Edition). http://www.moh.gov.my and http://www.acadmed.org.my.
8. Definitions and reporting framework for tuberculosis– 2013 revision (updated December 2014), by World Health Organization (WHO,2013). WHO/HTM/TB/2013.2.
9. Dr.Shiv Kumar Yadav, Dr.RahulDamor, Dr.Kantharia SL, Dr. Mani Tiwari(2016). Risk Factors of Multi Drug Resistant Tuberculosis among TB Patients in Surat District, Gujarat, India. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS);15(12):96-101. www.iosrjournals.org. DOI: 10.9790/0853-15120296101.
10. Feleke M, Belay T, Feleke M, Aschalew G, Setegn E, Gemechu K (2015). Multidrug resistant tuberculosis: prevalence and risk factors in districts of metema and west armachiho, Northwest Ethiopia. BMC Infectious Diseases 15: 461. DOI 10.1186/s12879-015-1202-7.
11. Fikadu TN(December,2012). Risk factors for Multidrug-Ressistant Tuberculosis in Addis Ababa, Ethiopia, December;2012.
12. Geisa F, Lorrayne B, Cláudia M, José L,Valdério d, Margareth P(2017). Risk factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. Rev Saúde Pública;51:41. https://doi.org/10.1590/S1518-8787.2017051006688
13. Global tuberculosis report by World Health Organization (WHO,2014). WHO/HTM/TB/2014.08.
14. Global tuberculosis report by World Health Organization (WHO,2015), 20th edition.(www.who.int).
15. Global tuberculosis report by World Health Organization (WHO,2016). WHO/HTM/TB/2016.13WHO/HTM/TB/2016.13.
16. Guidelines for clinical and programmatic management of TB, Leprosy and TB/HIV in Ethiopia,5thed(April,2012). Federal democratic republic of Ethiopia ministry of health,Addis Ababa.
17. Hussein B, Debebe T, Wilder-Smith A, Ameni G (2013). Drug susceptibility test on M.tuberculosis isolated from pulmonary tuberculosis in three sites of Ethiopia. Afri J Microbiol Res, 7(9):791–796.
18. [Internet]International atomic Energy agency: Detecting Drug Resistant Malaria and Tuberculosis in Africa. Highlighting achievements of Regional Technical Cooperation Project.
19. Kebede T, Shinesh T, Etsay N, Araya G,Dawit G, Kelemework A(2016). International Journal of Mycobacteriology:5. www.sciencedi rect.com.
20. Marahatta SB, Kaewkungwal J, Ramasoota P, Singhasivanon P (2010).Risk factors of Multidrug Resistant Tuberculosis in central Nepal; A pilot study.Kathmandu Univ Med J.;9(32):392 7, Vol.8/No. 3/Issue 32/Oct-Dec, 2010.
21. Marta G, Ana C, Denisa M, Raquel D (2014). Risk Factors for Drug-Resistant Tuberculosis. Journal of Tuberculosis Research; 2:111-118. http://www.scirp.org/journal/jtrhttp://dx.doi.org/10.4236/jtr.2014.23014.
22. Mulisa G, Workneh T, Hordofa N, Suaudi M, Abebe G, Jarso G (2015). Multi-drug resistant Mycobacterium tuberculosis and associated risk factors in the Oromia region of Ethiopia. International Journal of Infectious Diseases. http://dx.doi.org/10.1016/j.ijid.2015.08.013
23. Multidrug and extensively drug-resistant TB (M/XDR-TB,2010) global report on surveillance and response. WHO/HTM/TB/2010.3.
24. Multi-drug resistant Tuberculosis (MDR-TB,2016) update by World Health Organization (WHO). http://www.who.int/tb/areas-of-work/drug-resistant tb/treatment/resources/en/.
25. Muluken D, Ermias D, Sileshi B, Maereg W, JosephatNy(2016). Predictors of multidrug resistant tuberculosis among adult patients at Saint Peter Hospital Addis Ababa, Ethiopia. The Pan African Medical Journal ;25 (Supp 2):5/ DOI: 10.11604/pamj.supp.2016.25.2.9203.http://www.panafrican-med-journal.com/content/series/25/2/5/full.
26. Nsiande AL, Mtebe M, Peter MM, Ahmed A and Mecky IM (2016). Risk factors associated with multidrug resistant tuberculosis among patients referred to Kibong’oto Infectious Disease Hospital in northern Tanzania. Tanzania Journal of Health Research;18(4). Doi: http://dx.doi.org/10.4314/thrb.v18i4.2.
27. Parvaneh B, Payam T, Ehsan C, Atieh N, Narges A, Mehdi K, et.al (2009). Risk Factors Associated with Multidrug-Resistant Tuberculosis. Tanaffos,8(3): 17-21.
28. Selamawit H, Girmay M, Belaineh G, Muluken M, Alemayehu M, Pedro S (2013). Determinants of multidrug-resistant tuberculosis in patients who underwent first-line treatment in Addis Ababa: a case control study. BMC Public Health; 13:782. http://www.biomedcentral.com/1471-2458/13/782/ DOI: 10.1186/1471-2458-13-782.
29. Simon Logan(April,2013). Drug-Resistant Tuberculosis: Old Disease-New Threat.
30. TB CARE I(January,2014): Costs faced by multi-drug resistant tuberculosis patients during diagnosis and treatment. Report from a pilot study in Ethiopia. MDR-TB Patient Costs in Ethiopia.
31. TB Elimination(May,2012). Multidrug-Resistant Tuberculosis (MDR TB), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention by CDC; division of Tuberculosis Elimination. http://www.cdc.gov/tb.
32. WHO report (2011). Global Tuberculosis Control: Surveillance, planning, Financing. WHO/HTM/TB/2010, Geneva, Switzerland.
33. Wondemagegn M, Daniel M, Mulat Y, Aschalew A, Bayeh A (2015). Risk factors for multidrug resistant tuberculosis patients in Amhara National Regional State. African Health Sciences:15(2). DOI: http://dx.doi.org/10.4314/ahs.v15i2.9.
34. World Health Organization: WHO report (2011). Global Tuberculosis Control: Surveillance, planning, Financing. WHO/HTM/TB/2010. Geneva, Switzerland: WHO; 2010.
35. World Health Organization: WHO report (2013). Global Tuberculosis control, Geneva. (http://www.who.int/tb/data).

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