| dc.description.abstract | Introduction Multidrug resistant (MDR) tuberculosis (TB) indicates TB, which is resistant to
at least Rifampicin (R) and isoniazid (H) and remains one of the unresolved challenges in the
control of TB in Uganda. Current prevalence of MDR is 9.1% of all TB Cases in West Nile
region. The Development of drug resistance is majorly as a result of human related factors
coupled with poor lifestyle. The west Nile region of Uganda is a high burden region
especially among refugee settings with limited information on determinants of MDR TB. This
study aimed at identifying independent risk factors for MDR TB among tuberculosis patients
in the west Nile of Uganda to inform targeted interventions for the control and prevention of
MDR TB. The objectives of the study were to determine the socio demographic risk factors
and clinical risk factors for MDR TB among TB cases in the West Nile region of Uganda.
Method
An unmatched case control study design in a case to control ratio of 1:1 involving
quantitative methods was conducted in the West Nile region of Uganda. The study
enrolled138 cases (surviving MDR TB patients) and 138 controls (ordinary smear positive
TB patients) who were declared cured or who had completed treatment and were smear
negative at the end of the treatment period during the study period. Data was collected using
structured questionnaire with face to face interview. Data was coded and entered using
Microsoft access 2010 computer software and exported to Stata Version 14.0 SE for analysis.
Univariate analysis was done to compute means, frequencies and percentages. Bivariate
analysis was done using a reverse binary logistic regression model and results interpreted in
terms of odds ratios (COR) at 95% level of confidence and 0.05 level of significance. Factors
that were statistically associated with MDR TB at bivariate level of analysis were included in
a multivariate logistic regression model.
Results
A total of 276 respondents, 138 cases and 138 controls were enrolled in the study. Being on
HAART (AOR = 4.686; 95%CI: 2.250-9.761; p < 0.001) and presence of cavities on Chest X
ray at the point of starting TB treatment (AOR = 4.098; 95%CI: 1.228-13.677; p = 0.022)
were identified as significant independent risk factors for developing MDR TB.
Demographics, other clinical and behavioral characteristics of respondents were not
statistically associated with developing MDR TB.
Conclusion
Being on HAART and presence of cavities were identified as independent risk factors for
developing MDR TB. In order to reduce the burden of drug resistance, strategies for
controlling MDR TB in the West Nile region of Uganda should focus on HIV prevention,
intensive follow up strategies to ensure all patients started on anti-TB drugs do not default
their treatment, health practitioners routinely conduct chest x-rays for all TB patients at the
point of diagnosis for cavity identification and routinely conduct surveillance/monitoring of
all patients on HAART for MDR-TB. TB Patients with preexisting medical conditions such as
HIV/AIDS that weaken the body defence system require more attention from health workers
to ensure they adhere to their treatment to reduce the risk of developing MDR TB. | en_US |
