Risk Factors for Drug Resistance-Tuberculosis Among Tuberculosis Cases in Dire Dawa Administration, Ethiopia: Case Control Study

Abstract

Background: The 2011 world health organization global tuberculosis report estimated the presence of 650,000 cases of multi-drug resistance tuberculosis among the world’s 12.0 million prevalent cases of tuberculosis. Drug-resistant tuberculosis is a man-made problem, largely being the consequence of human error as a result of individual or combination of factors related to management of drug supply, patient management, prescription of chemotherapy, and patient adherence.

Objective:  To assess the risk factors associated with drug resistant tuberculosis among tuberculosis cases in Dire Dawa administration council from June to September 2014..

Methods: A health facility based unmatched case control study design was conducted.  All diagnosed drug resistant tuberculosis were taken as cases and randomly selected sensitive TB cases were considered as controls. The sample size was 270 (216 for control and 54 for cases) with case to control ratio 1:4, using Epi Info V.6.  Finally, data was collected by pre tested questionnaire and coded, edited, entered by Epi Info version 6.0 and analyzed by using SPSS version 16.0. Univariate, bivariate analysis, chi- square test and multivariable logistic analysis were conducted with consideration of P value < 0.05 with 95% CI.

Result: In multi logistic regression, three variables; unemployment, pre-treatment for TB and unsuccessful treatment outcome were found to fit the model. . That is, subjects treated before for TB were 190.7 times more likely to develop DR-TB than counterpart AOR=190.7 with 95% CI (14.53, 2502), unemployed subjects were 2.83 times more likely at risk of DR-TB than employed AOR=2.83 with 95% CI (1.02, 7.86) & those who were unsuccessfully treated were 343 times more likely at risk of DR-TB than with successful treatment outcome AOR=343 with 95% CI (29.9, 3985)

Conclusion: Previous history of treatment, unemployment and unsuccessful treatment outcome were significant risk factor associated with DR-TB. Therefore, DOTS program should be strengthened to increase patient adherence for successful treatment of patients.

Keywords: TB, drug resistance TB, Risk-factor