Determinants of multidrug-resistant tuberculosis in Addis Ababa, Ethiopia

Multidrug-resistant tuberculosis (MDR-TB) has been jeopardizing the global effort to prevent and control tuberculosis (TB). However, data on MDR-TB in Ethiopia in general, and in our study area in particular, are very scarce. The aim of this study was to identify determinants of MDR-TB in a cohort of patients managed in two referral hospitals of Addis Ababa, Ethiopia, between April 1, 2013 and June 30, 2013. A health facility-based case–control study was conducted. A total of 710 TB patients (229 confirmed MDR-TB and 481 drug susceptible TB patients) were enrolled in this study. Identified independent determinants for MDR-TB were contact history with a known TB patient (adjusted odds ratio [AOR]: 1.9, 95% CI: 1.1–3.3), previous history of TB treatment (AOR: 11.9, 95% CI: 6.8–21), history of hospitalization (AOR: 4.4 95% CI: 2.2–7.8), sputum-smear positivity (AOR: 1.9, 95% CI: 1.1–3.4), and social stigma (AOR: 5.1, 95% CI: 1.8–14.4). These identified factors should be considered for use in MDR-TB screening tool development if universal drug susceptibility testing is not possible. Moreover, TB infection control practices in health care settings should be further strengthened. As factors may vary from region to region, further broader studies need to be conducted in other parts of Ethiopia.