What question did this study set out to answer?

This study aims to assess the prevalence of rifampicin-resistant pulmonary tuberculosis and identify its associated factors among HIV-positive patients.

May 14, 2026Open Access

Prevalence and associated factors of rifampicin resistance pulmonary tuberculosis among HIV-positive patients in Bahir Dar, Northwest, Ethiopia

AAAlemayehu AbateAmhara Regional Health Bureau MAMelkamnesh AzageBahir Dar University AMAbaineh MunsheaBahir Dar University

Key Points

This study aims to assess the prevalence of rifampicin-resistant pulmonary tuberculosis and identify its associated factors among HIV-positive patients.
Conducted an institution-based cross-sectional study among 174 HIV-positive patients with presumptive pulmonary TB in Bahir Dar, Ethiopia.
Collected socio-demographic, behavioral, and clinical data using questionnaires and medical records.
Employed GeneXpert MTB/RIF assay for Mycobacterium tuberculosis detection and rifampicin resistance analysis.
Rifampicin resistance prevalence was found to be 10.9%, affecting 19 out of 174 patients.
Widowed individuals had significantly higher odds of rifampicin resistance (AOR = 15.9; 95% CI 3.01-83.62).
Participants with previous TB treatment were 2.91 times more likely to have rifampicin resistance (95% CI 1.04-8.18, p = 0.042).

Abstract

Tuberculosis (TB) remains a major public health problem and a leading cause of morbidity and mortality among people living with HIV, particularly in high-burden countries such as Ethiopia. TB control is severely compromised by rifampicin-resistant TB (RR-TB) due to limited treatment options and poorer outcomes. This study aimed to determine the prevalence of rifampicin-resistant pulmonary TB and identify associated factors among HIV-positive patients in Bahir Dar, Northwest Ethiopia. An institution-based cross-sectional study was conducted among 174 HIV-positive patients with presumptive pulmonary TB attending tuberculosis clinic in Bahir Dar, Northwest Ethiopia from October to December 2025. Socio-demographic, behavioral, and clinical data were collected using a structured questionnaire and medical record review. Sputum samples were analyzed using the GeneXpert MTB/RIF assay for detection of Mycobacterium tuberculosis and rifampicin resistance. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with rifampicin resistance. Statistical significance was set at p < 0.05. The prevalence of rifampicin resistance was 10.9%; found in 19 out of 174 presumptive TB patients. individuals who were widowed (AOR = 15.9; 95% CI 3.01-83.62) and divorced (AOR = 9.2; 95% CI 1.71-49.88) had considerably greater odds of rifampicin resistance than married people in multivariable analysis. Rifampicin resistance was 2.91 times more likely in participants with previous TB Treatment (95% CI 1.04-8.18, p = 0.042). There was an independent correlation between rifampicin resistance and smoking history (AOR = 3.4; 95% CI 1.02-11.49). The study revealed a high burden of rifampicin-resistant TB among HIV-positive patients in Bahir Dar. Significant predictors of rifampicin-resistant TB included social factors such as marital disruption, behavioral factors like smoking, and advanced HIV disease. Reducing the burden of RR-TB in HIV-infected populations requires strengthening early molecular diagnosis, increasing ART adherence, encouraging smoking cessation, and offering targeted social assistance for vulnerable groups.

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