Abstract
BackgroundEthiopia is one of the world health organization defined higher tuberculosis (TB) burden countries where the disease remains a massive public health threat. This study aimed to identify the prevalence and associated factors of multidrug-resistant tuberculosis (MDR-TB) using all armed force and civilian TB attendants in a tertiary level armed force hospital, where data for MDR-TB are previously unpublished.MethodsCross-sectional study was conducted from September 2014 to August 2015 in a tertiary level Armed Force Referral and Teaching Hospital (AFRTH), Ethiopia. Armed force members (n = 251) and civilians (n = 130) which has been undergone TB diagnosis at AFRTH were included. All the specimens collected were subjected to microscopic smear observation, culture growth and drug susceptibility testing. Data were analyzed using statistical package for social sciences following binary logistic regression and Chi-square. P-values < 0.05 were considered statistically significant.ResultsAmong 381 TB patients, 355 (93.2%) new and 26 (6.8%) retreatment cases were identified. Culture and smear positive TB cases were identified in 297 (77.9%) and 252 (66.1%) patients, respectively. The overall prevalence of MDR-TB in AFRTH was found 1.8% (1.3% for armed force members and 0.5% for civilian patients) all of which were previously TB treated cases. The entire treatment success rates were 92.6% achieved highest in the armed force (active and pension) than the civilian patients. The failure and dead cases were also found 2.5 and 4.6%, respectively. Using bivariate analysis, category of attendants and TB contact history were strong predictors of MDR-TB in armed force and civilian patients. Moreover, human immunodeficiency virus (HIV) infection also identified a significant (OR = 14.6; 95% CI = 2.3–92.1; p = 0.004) predicting factor for MDR-TB in armed force members. However, sex, age and body mass index were not associated factor for MDR-TB.ConclusionsIn AFRTH, lower prevalence of MDR-TB was identified in armed force and civilian patients that were significantly associated with category of attendants, HIV infection and TB contact history. Considering armed force society as one segment of population significantly helps to plan a better MDR-TB control management, especially for countries classified as TB high burden country.
Highlights
Ethiopia is one of the world health organization defined higher tuberculosis (TB) burden countries where the disease remains a massive public health threat
The Armed force referral and teaching hospital (AFRTH) provides service for a large number of TB patients per year, the data included in this study were only collected from those patients who had complete information registered according to National Tuberculosis and Leprosy Control Program (NTLCP) guideline of Ethiopia [7] adopted from World Health Organization (WHO)
Based on the category of patients registered in AFRTH, active armed force, pension and civilians were found 216 (56.7%), 35 (9.2) and 130 (34.1%), respectively
Summary
Ethiopia is one of the world health organization defined higher tuberculosis (TB) burden countries where the disease remains a massive public health threat. Illness of latent TB manifested only when the bacteria become active. There are many factors that contribute the latent TB bacteria become active including human immunodeficiency virus (HIV), older age, diabetics, close contact with an active case of TB disease and other immunocompromising illness conditions [1, 4]. Ethiopia is one of the WHO defined higher TB burden countries where the disease remains a massive public health threat and an economic burden. World Health Organization in 2016 listed Ethiopia 10th out of the 30 high TB priority countries in the globe [1]
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