Prevalence of drug-resistant Mycobacterium tuberculosis and its associated factors among tuberculosis patients attending Dilla university referral hospital, Ethiopia.

Abstract

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB) and is the second leading cause of death from contagious diseases worldwide. Ethiopia is among the 30 countries with the highest burden of TB and TB/HIV co-infection. The emergence and spread of drug-resistant TB present significant challenges to TB care and control efforts, particularly multi-drug-resistant TB, which poses a serious public health issue in low-income countries such as Ethiopia. This study aimed to determine the prevalence of drug-resistant TB and its associated factors among TB patients in Dilla University Referral Hospital (DURH).

Method: A prospective cross-sectional study was conducted from March-2024 to May-2024 among 216 pulmonary TB patients attending DURH. Gene Xpert MTB/RIF Ultra and Xpert MTB/XDR assay was used to assess the pattern of drug resistance in TB. The Xpert MTB/RIF Ultra assay was used to detect rifampicin resistance, while the Xpert MTB/XDR assay was employed to identify isoniazid resistance and resistance to second-line anti-TB drugs when rifampicin resistance was detected. Data were analyzed by using the Statistical Package for Social Sciences (SPSS) version 25.

Result: In this study, out of 216 confirmed MTB cases, 5 (2.3%) were identified as drug-resistant TB (DR-TB), with mono-resistance to rifampicin and isoniazid at 1.4% and 0.9%, respectively. The statistical analysis revealed a significant difference in DR-TB prevalence between those with and without a history of anti-TB treatment (p = 0.001). Notably, isoniazid mono-resistant TB was more prevalent among individuals with diabetes mellitus and those with a history of previous treatment, showing p-values of 0.018 and 0.015, respectively.

Conclusion: Among the 216 confirmed TB cases, 5 cases of DR-TB were identified, accounting for 2.3%. DR-TB was more prevalent in patients with a history of anti-TB treatment, highlighting the urgent need for enhanced early detection and improved treatment monitoring. Additionally, isoniazid mono-resistant TB was notably prevalent in individuals with diabetes mellitus and prior treatment history, with p-values of 0.018 and 0.015, respectively. Targeted interventions for these high-risk groups are essential to address drug resistance in TB, enabling us to effectively tackle the emergence of drug-resistant TB at both local and national levels.