Magnitude, predictors, and trends of multidrug-resistant tuberculosis among tuberculosis patients at Debre Markos, Northwest, Ethiopia: a five-year retrospective study.

BACKGROUND

The emergence of multidrug-resistant tuberculosis (MDR-TB) is a threat to the people of resource-limited countries, such as Ethiopia. This study aimed to assess the magnitude, predictors and trends of multidrug-resistant tuberculosis among patients with pulmonary tuberculosis (TB) at Debre Markos Comprehensive and Specialized Hospital (DMCSH), Northwest Ethiopia.

MATERIALS AND METHODS

A retrospective cross-sectional study was conducted among patients with TB treated at the directly observed treatment short course (DOTS) clinic at DMCSH from 1 June 2016 to 1 June 2020. Data from 1509 patients with TB registered in the clinic were retrieved from medical records. Statistical analysis was performed using SPSS v.24. The frequency of variables is presented via tables and figures. Logistic regression was fitted to predictors of MDR-TB, and a value < 0.05 was considered statistically significant.

RESULTS

Overall, data from 1509 patients with pulmonary TB were retrieved during the study. The overall prevalence of MDR-TB was 4.1%. Variables such as sex, human immunodeficiency virus (HIV) status, lesion on chest X-ray, and a history of anti-TB treatment were significantly associated with MDR-TB. The trend of MDR-TB decreased by 40% in 2017, 29% in 2018, and 10% in 2019, but increased by 21% in 2020.

CONCLUSIONS AND RECOMMENDATIONS

The prevalence of MDR-TB among patients with pulmonary TB was comparable to the national rate. Key risk factors for MDR-TB included male sex, prior TB treatment, HIV infection, and chest X-ray abnormalities. The increasing trend in 2020 highlights the need for strengthened TB treatment adherence counselling and further prospective studies to explore additional predictors of MDR-TB.