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.