Risk Factors for Multidrug-Resistant Tuberculosis and Characteristics of Cases: A Case-Control Study of Patients Attending ALERT General Hospital in Addis Ababa, Ethiopia
Background:Tuberculosis
remains a major public-health problem in the world, despite several efforts to
improve case identification and treatment. Particularly multidrug-resistant
tuberculosis is becoming a major threat to tuberculosis control programs in
Ethiopia which seriously threatens the control and prevention efforts and is
associated with both high death rates and treatment costs. Methods: A
case-control study was conducted to assess risk factors and characteristics of
MDR-TB cases at ALERT Hospital, Addis Ababa, Ethiopia, where cases were 167
MDR-TB patients, while controls were newly diagnosed and bacteriologically
confirmed pulmonary TB cases of similar number, who were matched by sex and age
of 5-years interval. Results: The socio-demographic characteristics of
the participants indicated that majority (53.3%) were males and 46.7% females;
a little over half of cases (55.1%) were in the age group 26 - 45 years,
whereas 46.7% of controls were in this age group. According to the
multivariable logistic regression analysis, previous history of hospital
admission was the only factor that was identified as predictor which increased
risk to develop MDR-TB by almost twenty times (AOR = 19.5; 95% CI: 9.17 -
41.62) and P-value of <0.05. All other studied factor such as being
unemployed, family size, having member of household member with TB, and history
of visiting hospital in past 12 months etc., didn’t show any statistically
significant association. Conclusion: The study identified previous
history of hospital admission as independent predictors for the occurrence of
MDR-TB, while other studied variables didn’t show any strong association. The
findings added to the pool of knowledge emphasizing the need for instituting
strong infection control practice at health care facilities to prevent nosocomial
transmission of MDR-TB.
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