Assessing the determinants of drug-resistant tuberculosis in selected hospitals in Tigray region, Northern Ethiopia: a case-control study

BACKGROUND: Drug-resistant tuberculosis (DR-TB) is a significant challenge to the national tuberculosis (TB) control program in Ethiopia. The Tigray region in northern Ethiopia has shown a surge in the incidence of DR-TB cases. However, the determinants of DR-TB in the region are not studied. This study is aimed at identifying the factors associated with the development of DR-TB in the Tigray region of northern Ethiopia. METHODS: The study used an unmatched case-control design to identify determinants of DR-TB in the Tigray region, northern Ethiopia, whereby 86 patients and 86 controls who registered for TB treatment follow-up in selected hospitals were recruited. Trained nurses collected both primary and secondary data, which were analyzed using descriptive statistics and binary logistic regression. The test statistics was conducted with a 95% confidence level, and a p-value of less than 0.05 was considered significant. RESULTS: The study included 86 patients with DR-TB (cases) and an equal number of patients with drug-susceptible (controls). The case and control groups had 38 (44.2%) and 47 (54.7%) males, respectively. The study revealed the study participants with male gender (adjusted odds ratio AOR = 4.9, 95% confidence interval [CI: 1.2-19.9), single marital status (AOR = 13.6, 95% CI: 2.3-81.2), history of TB treatment (AOR = 58.2, 95% CI: 11.2-302.1), experienced a delay of more than 60 days before TB diagnosis (AOR = 4.8, 95% CI: 1.2-19.3), interrupted treatment at least once (AOR = 4.9, 95% CI: 1.02-23.9), and unsuccessful treatment outcome at first treatment (AOR = 7.6, 95% CI: 1.8-35.9) had a higher risk of DR-TB. CONCLUSIONS: The study highlights determinants of DR-TB in the region, including gender, marital status, delayed diagnosis (over 60 days), previous treatment history, interrupted treatment, and unsuccessful treatment outcomes during initial treatment. It is recommended that healthcare providers focus on targeted interventions, such as supporting males and unmarried individuals, ensuring early diagnosis and prompt initiation of treatment, improving treatment adherence, and providing tailored support for patients with histories of incomplete treatment and unsuccessful initial treatment outcomes.