Khat Chewing and Clinical Conditions Determine the Epidemiology of Primary Drug Resistance Tuberculosis in Amhara Region of Ethiopia: A Multicenter Study
- PMID: 34234475
- PMCID: PMC8255900
- DOI: 10.2147/IDR.S316268
Khat Chewing and Clinical Conditions Determine the Epidemiology of Primary Drug Resistance Tuberculosis in Amhara Region of Ethiopia: A Multicenter Study
Abstract
Background: Rifampicin and/or multidrug-resistant tuberculosis (RR/MDR-TB) remains an uncontrolled public health emergency that has been synergized by the recently increased person-to-person transmission in the community as primary RR/MDR-TB, which is defined as RR/MDR-TB in new TB patients with no prior exposure to anti-TB treatment for more than one month. This study aimed to measure the prevalence and associated factors of primary drug-resistance among drug-resistant tuberculosis patients, as evidenced by the Amhara region treatment initiating centers.
Methods: An institutional-based multicenter cross-sectional study was conducted from September 2010 to December 2017, among 580 RR/MDR-TB patients on the second-line anti-TB drug in the Amhara regional state. Data were collected from patient charts and registration books using a standardized data abstraction sheet. The data were entered using Epi-data 4.2.0.0 and transferred to Stata 14 software for further data management and analysis. A bivariable and multivariable binary logistic model was run subsequently, and finally, a p-value of less than 0.05 with a 95% confidence interval (CI) was used to declare the significance of the explanatory variable.
Results: The magnitude of primary drug resistance among drug-resistant tuberculosis patients was 15.69% (95% CI: 12.94, 18.89). Alcohol drinking (adjusted odds ratio [AOR] = 0.31, 95% CI: 0.12-0.82), khat chewing (AOR = 4.43; 95% CI: 1.67-11.76), ambulatory and bedridden functional status (AOR = 0.43; 95% CI: 0.24-0.76) and (AOR = 0.41; 95% CI: 0.19-0.91), respectively, positive sputum smear result (AOR = 0.48; 95% CI: 0.26-0.90), and HIV coinfection (AOR= 2.31; 95% CI: 1.31-4.06) remained statistically significant associated factors of primary RR/MDR-TB.
Conclusion: Primary drug resistance is a public health problem in the study setting. Different behavioral and clinical conditions were significant factors of primary drug-resistant development. Mitigation strategies targeted on the patient's clinical condition, substance-related behaviors, and universal DST coverage might be very important for early detection and treatment of RR/MDR-TB to prevent community-level transmission.
Keywords: Ethiopia; clinical conditions; epidemiology of primary RR/MDR-TB.
© 2021 Kassa et al.
Conflict of interest statement
The authors report no conflicts of interest in this work.
Figures



References
-
- World Health Organization. Global Tuberculosis Report. Geneva: World Health Organization; 2019.
-
- Bloom BR, Atun R, Cohen T, et al. Tuberculosis. In: Holmes KK, Bertozzi S, Bloom BR, Jha P, editors. Major Infectious Diseases. Washington (DC): The International Bank for Reconstruction and Development/The World Bank © 2017 International Bank for Reconstruction and Development/The World Bank; 2017.
-
- Ministry of Health-Ethiopia. National Programmatic Management of Drug-Resistant TB (PMDT) in Ethiopia. Ministry of Health-Ethiopia; 2019.
LinkOut - more resources
Full Text Sources