Factors Associated With Multi-Drug Resistant (MDR) Tuberculosis among Suspected Mdr-Tb Cases in Eastern Region, 2014 – 2018

Abstract

Background: Tuberculosis (TB) is a global public health menace especially in developing countries where it contributes significantly to the top ten causes of mortality. In Eastern region, the TB burden remains high and priority. The increasing trend of anti-TB drug resistance is a great challenge. This study assessed the resistance pattern and factors associated with MDR-TB cases among suspected MDR-TB cases in Eastern region, from 2014 to 2018. Methods: This study was conducted in the Eastern region of Ghana using medical records from 1st January 2014 to 31st December 2018. Variables studied were socio-demographic factors, clinical, anthropometric and laboratory characteristics. Medical records were entered into excel and imported into STATA version 15. Data were cleaned and analyzed using STATA statistical analysis. Frequencies, proportions and tables were generated. Pearson’s Chi-square test was used to determine factors associated with MDR-TB cases and multiple logistic regression was used to determine the magnitude of association. A test of significance was set at 0.05. Results: All forms of MDR-TB accounted for 9.3% (47/503, 95% CI: 6.9-12.2) of cases with 39.5% among new cases and 6.9% among previously treated cases. The overall resistance to at least any of the first line anti-TB drugs was 39% (196/503) with Rifampicin been the most resistant. HIV positive test results (aOR=3.80, 95% CI: 1.09-13.26), type of case (aOR=0.07, 95% CI: 0.05-0.24) and sputum smear positive results (aOR=12.88, 95% CI: 5.47-30.34) were significantly associated with MDR-TB. Conclusion: One in every ten suspected MDR-TB case was confirmed MDR-TB. Burden of MDR-TB was high in newly infected cases. Factors associated with MDR-TB were HIV positive results, sputum smear positive results and type of case. Therefore, improving early case detection and treatment, building capacity of laboratory for Drug Susceptibility Testing (DST), strengthening TB infection control and prevention activities and complying to DOTS strategy are recommended to minimize the menace of MDR-TB. Keywords: MDR-TB, Drug resistance, Tuberculosis