OALibJ  Vol.1 No.3 , June 2014
Risk Factors of Multi-Drug Resistant Tuberculosis in Addis Ababa, Ethiopia: A Matched Case-Control Study
Abstract: Objective: This study determined risk factors associated with MDR-TB among MDR TB/HIV co-infected cases and TB/HIV co-infected controls attending ART clinics in Addis Ababa. Methods: A health facility based 1:3 matched case-control study was conducted from January to February 2013. Study subjects were selected using multistage probability sampling. Cases were matched to controls using age, sex and HIV sero-positive status. Bivariate and multivariate conditional logistic regression models were used to determine risk factors associated with MDR-TB. Results: A total of 96 cases were matched to 288 controls. Risk factors for MDR-TB were found to be: previous TB treatment (AOR = 5.7, 95% CI: 1.82 - 8.32), having opportunistic infection (AOR = 2.23, 95% CI: 1.27 - 3.92), primary education (AOR = 1.37, 95% CI: 1.08 - 1.74), unemployment (AOR = 3.44, 95% CI: 1.82 - 6.48), long distance of the health facility (AOR = 10.18, 95% CI: 1.22 - 84.77), 1 hr-24 hrs to reach the health facility (AOR = 2.19 ,95% CI: 1.15 - 4.15) and >24 hrs to reach the health facility (AOR = 4.56, 95% CI: 1.14 - 18.25). Conclusion and Recommendation: The identified risk factors should be given priority by TB control programs under Addis Ababa health bureau to control MDR-TB. In addition, these findings need to be corroborated with multi-centre case-control studies to bring out nationally relevant risk factors for MDR-TB.
Cite this paper: Deressa, M. and Demissie, M. (2014) Risk Factors of Multi-Drug Resistant Tuberculosis in Addis Ababa, Ethiopia: A Matched Case-Control Study. Open Access Library Journal, 1, 1-8. doi: 10.4236/oalib.1100489.

[1]   Seung, K.J., Omatayo, D.B., Keshavjee, S., Furin, J.J., Farmer, P.E., et al. (2009) Early Outcomes of MDR-TB Treatment in a High HIV-Prevalence Setting in Southern Africa. PLoS ONE, 4, Article: e7186.

[2]   Calver, A.D., Falmer, A.A., Murray, M., Strauss, O.J., Streicher, E.M., et al. (2010) Emergence of Increased Resistance and Extensively Drug-Resistant Tuberculosis despite Treatment Adherence, South Africa. Emerging Infectious Diseases, 16, 264-271.

[3]   Hassim, S., Shaw, P.A., Sangweni, P., Malan, L., Ntshani, E., et al. (2010) Detection of a Substantial Rate of Multidrug-Resistant Tuberculosis in an HIV-Infected Population in South Africa by Active Monitoring of Sputum Samples. Clinical Infectious Diseases, 50, 1053-1059.

[4]   Gandhi, N.R., Shah, N.S., Andrews, J.R., Vella, V., Moll, A.P., et al. (2010) HIV Co-Infection in Multidrug- and Extensively Drug-Resistant Tuberculosis Results in High Early Mortality. American Journal of Respiratory and Critical Care Medicine, 181, 80-86.

[5]   Dheda, K., Shean, K., Zumla, A., Badri, M., Streicher, E.M., et al. (2010) Early Treatment Outcomes and HIV Status of Patients with Extensively Drug-Resistant Tuberculosis in South Africa: A Retrospective Cohort Study. Lancet, 375, 1798-1807.

[6]   WHO (2012) Tuberculosis Global Facts.

[7]   Agonafi, M., et al. (2010) Phenotypic and Genotypic Analysis of Multidrug-Resistant Tuberculosis in Ethiopia. International Journal of Tuberculosis and Lung Disease, 14, 1259-1265.

[8]   WHO (2010) Multidrug and Extensively Drug-Resistant TB (M/XDR-TB): Global Report on Surveillance and Response.

[9]   Demissie, M., Gebeyehu, M. and Berhane, Y. (2005) Primary Resistance to Anti-Tuberculosis Drugs. International Journal of Tuberculosis and Lung Disease, 1, 64-67.

[10]   Abate, G., Miörner, H., Ahmed, O. and Hoffner, S.E. (2006) Drug Resistance in Mycobacterium Tuberculosis Strains Isolated from Re-Treatment Cases of Pulmonary Tuberculosis: Susceptibility to First-Line and Alternative Drugs. International Journal of Tuberculosis and Lung Disease, 2, 580-584.

[11]   Meskel, D.W., Abate, G., Lakew, M., Goshu, S. and Aseffa, A. (2008) Anti-Tuberculosis Drug Resistance among Retreatment Patients. Ethiopian Medical Journal, 46, 219-225.

[12]   Addis Ababa Regional Health Bureau (AARHB) (2010) Operational Manual for Regional HIV/AIDS Care and Treatment Catchments Team Activities.

[13]   Ethiopian Federal Ministry of Health and Federal HIV/AIDS Prevention and Control Office (2007) Single Point HIV Prevalence Estimate.

[14]   FMOH (2008) Tuberculosis, Leprosy and TB/HIV Prevention and Control Programme. Addis Ababa.

[15]   Addis Ababa HIV/AIDS Prevention & Control Office (2009) Anti-Retroviral Treatment (ART) Sites.

[16]   Liang, L.B., Wu, Q.H., Gao, L.J., Hao, Y.H., Liu, C.J., Xie, Y.G., et al. (2012) Factors Contributing to the High Prevalence of Multidrug-Resistant Tuberculosis: A Study from China. Thorax, 67, e632-e638.

[17]   Merza, M.A., et al. (2011) Anti-Tuberculosis Drug Resistance and Associated Risk Factors in a Tertiary Level TB Centre in Iran. Journal of Infection in Developing Countries, 5, 511-519.

[18]   Gler, M.T. (2012) Impact of Patient and Program Factors on Default during Treatment of Multidrug-Resistant Tuberculosis. International Journal of Tuberculosis and Lung Disease, 16, 955-960.

[19]   Bushra, A.W. (2012) Risk Factors for Multi-Drug Resistant TB (MDR-TB) among Tuberculosis Patients in Saint Peter TB Specialized Hospital.

[20]   Casal, M. (2005) A Case-Control Study for Multidrug-Resistant Tuberculosis: Risk Factors in Four European Countries. Microbial Drug Resistance, 11, 62-67.