Risk factors for multidrug-resistant tuberculosis among tuberculosis patients: a case-control study

Multidrug-resistant tuberculosis (MDR-TB) did not receive major attention until recently in sub-Saharan Africa where the tuberculosis incidence and risk factors are highest. Factors leading to development of drug resistance need to be understood to develop appropriate control strategies for national programs. The objective of this study was to identify the risk factors for MDR-TB among tuberculosis patients.

A case-control study was conducted to assess sociodemographic, behavioral and clinical risk factors using a structured questionnaire and clinical record reviewing. The data were entered and analyzed using SPSS windows version 16. Descriptive analysis was done to generate summary values for the variables and those significant variables in the bivariate analysis at p-value less than 0.25 were entered to multivariable logistic regression to identify independent determinants. Statistical significance was declared at p-value less than or equal to 0.05.

A total of 90 cases and 90 controls were included in the study. Age of respondents (adjusted odds ratio [AOR] =7; 95% confidence interval [CI]: 2.6-24.5), living in a household with only one room (AOR=5; 95%CI: 1.68-15.38), history of previous treatment (AOR=21; 95% CI: 17.8-28) and being HIV infected (AOR=3.1; 95%CI: 1.02-9.4) were found to be independent predictors of MDR-TB.

In light of these findings, the strategies in controlling MDR-TB should emphasize on patients with HIV coinfection, young patients, those who have a history of previous treatment, and those living in crowded places.