Multidrug-resistant Mycobacterium tuberculosis and associated risk factors in Oromia Region of Ethiopia

Objective: The aim of this study was to determine risk factors for tuberculosis (TB) caused by multidrug-resistant Mycobacterium tuberculosis (MDR-TB) in Oromia Region, Ethiopia. Methods: A 6-month case-control study was performed in 2013-14. Sputum samples and standardized questionnaire data (demographics, treatment, TB contact history, underlying disease, history of imprisonment) were collected from cases with suspected MDR-TB aged ≥18 years. Sputum was processed locally in the Oromia Public Health Laboratory using standard techniques. Data from MDR-TB cases and TB-positive controls were compared using logistic regression analysis. For each factor, the association with outcome variables was estimated by calculating the odds ratio (OR) together with the 95% confidence interval (95% CI). Results: Of 439 suspected MDR-TB cases, 265 had a confirmed M. tuberculosis infection, of whom 88 (33%) had laboratory-confirmed MDR-TB. Over two-thirds (65%) were between 18 and 39 years of age. On multivariate analysis, an occupation of farming, known TB contact history, alcohol use, HIV infection, previous known TB history, and previous TB treatment outcome were predictors of MDR-TB. Conclusions: The rate of MDR-TB was high among suspected cases in the Oromia Region of Ethiopia. Local MDR-TB detection capacity and local epidemiology studies are essential to detect MDR-TB and guide the use of the sparse resources to optimize MDR-TB control. If TB is suspected, the presence of any of the above factors should alert Oromia Region clinicians and public health professionals to screen for MDR-TB.