Determinants of Multidrug-Resistant Mycobacterium tuberculosis Infection: A Multicenter Study from Southern Ethiopia

Figures & data

Table 1 Socio-Demographic Characteristics of Respondents at Selected Hospitals in Southern Ethiopia, 2021

Variables	Categories	Cases (N=67) Number (%)	Control (N=124) Number (%)	Total (N=191) Number (%)
Age (in years)	< 25 years	23(34.3)	42(33.9)	65(34)
	25–34 years	22(32.8)	51(41.1)	73(38.2)
	35–44 years	12(17.9)	17(13.7)	29(15.2)
Sex	Male	38(56.7)	61(49.2)	99(51.8)
	Female	29(43.3)	63(50.8)	92(48.2)
Marital status	Single	35(52.2)	62(50)	97(50.8)
	Married	29(43.3)	51(41.1)	80(41.9)
	Divorced	1(1.5)	1(0.8)	2(1)
	Widowed	2(3)	10(8.1)	12(6.3)
Residence	Rural	26(38.8)	2(1.6)	28(14.56)
	Urban	41(61.2)	122(98.4)	163(85.34)
Education status	Unable to read/write	22(32.8)	15(12.1)	37(19.4)
	Able to read or write	18(26.9)	7(5.6)	25(13.1)
	Primary	13(19.4)	41(33.1)	54(28.3)
	Secondary	11(16.4)	37(29.8)	48(25.1%)
	Colleges and above	3(4.5)	24(19.4)	27(14.1%)
Occupational status	Government employ	5(7.5)	19(153)	24(12.57)
	Merchant	10(14.9)	26(21)	36(18.85)
	House wife	15(22.4)	23(18.5)	38(19.9)
	Daily laborer	10(14.9)	15(12.1)	25(13.09)
	Student	10(14.93)	31(25)	41(21.47)
	Unemployed	6(8.96)	4(3.23)	10(5.24)
	Other	11(16.42)	6(4.84)	17(8.9)
History of being in a refugee camp	Yes	5(7.46)	3(2.4)	8(4.2)
	No	62(92.54)	121(97.6)	183(95.8)
If yes, when were you in refugee?	Within this 2 years	4(80)	1(33.3)	5(62.5)
	Before 2 years	1(20)	2(66.7)	3(37.5)
History of imprisonment	Yes	6(9)	6(4.8)	12(6.3)
	No	61(91)	118(95.2)	179(93.7)
If yes, when were you in prison	Within this 2 years	1(16.7)	1(16.7)	2(16.7)
	Before 2 years	5(83.3)	5(83.3)	10(83.3)
Transportation system	Private car	3(4.5)	0(0)	3(1.6)
	Public	65(97)	117(94.4)	182(95.3)
	By foot	46(68.7)	89(71.8)	135(70.7)
Disclosure of TB status	Yes	62(92.5)	116(93.5)	178(93.2)
	No	5(7.5)	8(6.5)	13(6.8)
Faced social stigma	Yes	28(41.8)	13(10.5)	41(21.47)
	No	39(58.2)	111(89.5)	150(78.53)

Table 2 Housing Condition of Respondents at Selected Hospitals in Southern Ethiopia, 2021

Variables	Categories	Cases (N=67) Number (%)	Control (N=124) Number (%)	Total (N=191) Number (%)
Number of rooms in a house	1 room	34(50.75)	29(23.39)	63(32.98)
	2 rooms	19(28.36)	23(18.55)	42(21.99)
Number of people living in a house	3 rooms	6(8.96)	46(37.1)	52(27.23)
	≥ 4 rooms	8(11.94)	26(20.97)	34(17.8)
	1–2 people	9(13.43)	31(25)	40(20.94)
	3–4 people	16(23.88)	38(30.65)	54(28.27)
	5–6 people	31(46.27)	40(32.26)	71(37.17)
	≥ 7 people	11(16.42)	15(12.1)	26(13.61)
The rooms have windows	Yes	58(86.6)	122(98.4)	180(94.2)
	No	9(13.4)	2(1.6)	11(5.8)
Open the window daily	Yes	43(74.1)	109(89.3)	152(84.4)
	No	15(25.9)	13(10.7)	28(15.6)

Table 3 Behavioral Factors of Respondents at Selected Hospitals in Southern Ethiopia, 2021

Variables	Categories	Cases (N=67) Number (%)	Control (N=124) Number (%)	Total (N=191) Number (%)
Ever taking alcohol	Yes	23(34.33)	26(20.97)	49(25.7)
	No	44(65.67)	98(79.03)	142(74.3)
Current alcohol drinker	Yes	9(39.1)	5(19.2)	14(28.6)
	No	14(60.9)	21(80.8)	35(71.4)
Ever smoke a cigarette	Yes	15(22.39)	12(9.68)	27(14.1)
	No	52(77.61)	112(90.32)	164(85.9)
Current cigarette smoker	Yes	5(33.3)	1(8.3)	6(22.2)
	No	10(66.7)	11(91.7)	21(77.8)
Ever chewing Khat	Yes	15((22.4)	21(16.9)	36(18.8)
	No	52(77.6)	103(83.1)	155(81.2)
Current Khat chewer	Yes	7(46.7)	8(38.1)	15(41.7)
	No	8(53.3)	13(61.9)	21(58.3)
Hours of sleep per day	< 8 hours	12(17.91)	10(8.06)	22(11.5)
	≥ 8 hours	55(82.09)	114(91.94)	169(88.5)

Table 4 Treatment-Related Factors of Respondents at Selected Hospitals in Southern Ethiopia, 2021

Variable	Categories	Cases (N=67) Number (%)	Control (N=124) Number (%)	Total (N=191) Number (%)
History of previous TB treatment	Yes	35(52.24)	15(12.1)	50(26.2)
	No	32(47.76)	109(87.9)	141(73.8)
Times of history of previous TB treatment	1	20(57.1)	7(46.7)	27(54)
	≥ 2	15(42.9)	8(53.3)	23(46)
Previous TB treatment outcome	Cured	5(14.3)	4(26.7)	9(18)
	Treatment completed	9(25.7)	9(60)	18(36)
	Relapse	4(11.4)	2(13.3)	6(12)
	Treatment failure	12(34.3)	0(0)	12(24)
	Default	5(14.3)	0(0)	5(10)
History of hospitalization for previous TB treatment	Yes	14(40)	12(80)	26(52)
	No	21(60)	3(20)	24(48)
History of anti-TB interruption at least a day in previous TB treatment	Yes	19(54.3)	5(33.3)	24(48)
	No	16(45.7)	10(66.7)	26(52)
History of adverse effect of Anti-TB drug in previous TB treatment	Yes	31(88.6)	8(53.3)	39(78)
	No	4(11.4)	7(46.7)	11(22)
Type of adverse effect	Gastrointestinal problem (nausea, vomiting)	23(74.2)	8(100)	31(79.5)
	Skin problems	4(12.9)	0(0)	4(10.3)
	Liver disease	0(0)	1(12.5)	1(2.6)
	Anemia	3(9.7)	1(12.5)	4(10.3)
	Hearing loss	2(6.5)	0(0)	2(5.1)
	Numbness of the hands and feet	17(54.8)	4(50)	21(53.8)
Duration anti-TB treatment previous TB treatment	≤ 7 months	25(71.4)	10(66.7)	35(70)
	>7 months	10(28.6)	5(33.3)	15(30)
First line anti-TB taken	Yes	31(88.6)	13(86.7)	44(88)
	No	4(11.4)	2(13.3)	6(12)

Abbreviation: TB, tuberculosis.

Table 5 Clinical Factors of Respondents at Selected Hospitals in Southern Ethiopia, 2021

Variable	Categories	Cases (N=67) Number (%)	Control (N=124) Number (%)	Total (N=191) Number (%)
Type of TB	PTB	59(88.06)	74(59.68)	133(69.63)
	EPTB	8(11.94)	50(40.32)	58(30.37)
Sputum smear result	Positive	49(83.05)	32(43.24)	81(60.9)
	Negative	10(16.95)	42(56.76)	52(39.1)
History of contact with known MDR-TB patient	Yes	12(17.91)	10(8.06)	22(11.5)
	No	55(82.09)	114(91.94)	169(88.5)
History of chronic disease	Yes	5(7.5)	11(8.9)	16(8.4)
	No	62(92.5)	113(91.1)	175(91.6)
History of HIV	Yes	2(40)	8(72.7)	10(62.5)
	No	3(60)	3(27.3)	6(37.5)
History of diabetes mellitus	Yes	1(20)	2(18.2)	3(18.8)
	No	4(80)	9(81.8)	13(81.3)
History of cardiac disease	Yes	2(40)	2(18.2)	4(25)
	No	3(60)	9(81.8)	12(75)

Abbreviations: EPTB, extra pulmonary tuberculosis; PTB, pulmonary tuberculosis; TB, tuberculosis; HIV, human immune deficiency syndrome; MDR-TB, multi-drug resistant tuberculosis.

Figure 1 The proportion of body mass index (BMI) of respondents at selected hospitals in southern Ethiopia, 2021.

Table 6 Bivariable and Multivariable Binary Logistic Regression Analysis on the Determinants of Multi-Drug Resistant TB Among TB Patients at Selected Hospitals in Southern, Ethiopia, 2021

Variables	Categories	Cases (N=67) Number (%)	Control (N=124) Number (%)	COR (95% CI)	AOR (95% CI)
Educational status	Unable to read/write	22(32.8)	15(12.1)	13.3(3.4–51.9)	8.9(0.55–145)
	Able to read or write	18(26.9)	7(5.6)	17(3.8–76.7)	14.1(0.83–237)
	Primary education	13(19.4)	41(33.1)	2.5(0.65–9.81)	0.9(0.09–10.4)
	Secondary education	11(16.4)	37(29.8)	2.3(0.6–9.41)	2.6(0.27–24.9)
	Colleges and above	3(4.5)	24(19.4)	1	1
Occupation	Government employ	5(7.5)	19(153)	1	1
	Merchant	10(14.9)	26(21)	1.4(0.42–4.97)	0.10(0.007–1.5)
	House wife	15(22.4)	23(18.5)	2.4(0.76–8.06)	0.28(0.02–3.5)
	Daily laborer	10(14.9)	15(12.1)	2.5(0.71–9.01)	0.2(0.01–2.5)
	Student	10(14.93)	31(25)	1.2(0.36–4.13)	0.9(0.09–8.6)
	Unemployed	6(8.96)	4(3.23)	5.7(1.14–28.33)	0.98(0.06–15.9)
	Other	11(16.42)	6(4.84)	6.9(1.71–28.25)	1.3(0.1–15.6)
Ever been in refuge	Yes	5(7.46)	3(2.4)	3.2(0.75–14.05)	7.4(0.38–147)
	No	62(92.54)	121(97.6)	1	1
Stigma	Yes	28(41.8)	13(10.5)	6.1(2.88–13.00)	8.9(2.33–34.6)**
	No	39(58.2)	111(89.5)	1	1
Number of rooms	1 room	34(50.75)	29(23.39)	3.8(1.49–9.70)	12.3(2.3–63.5)**
	2 rooms	19(28.36)	23(18.55)	2.6(0.98–7.28)	9.7(1.7–54.8)*
	3 rooms	6(8.96)	46(37.1)	0.4(0.13–1.35)	0.4(0.03–3.1)
	≥ 4 rooms	8(11.94)	26(20.97)	1	1
Family size	1–2 people	9(13.43)	31(25)	1	1
	3–4 people	16(23.88)	38(30.65)	1.4(0.56–3.72)	0.6(0.1–3.6)
	5–6 people	31(46.27)	40(32.26)	2.6(1.10–6.42)	1.5(0.25–8.8)
	≥ 7 people	11(16.42)	15(12.1)	2.5(0.86–7.40)	0.4(0.03–4.9)
Cigarette smoking	Yes	15(22.39)	12(9.68)	9.9(1.13–86.75)	0.4(0.06–2.8)
	No	52(77.61)	112(90.32)	1	1
Alcohol drinking	Yes	23(34.33)	26(20.97)	1.9(1.01–3.82)	2.2(0.5–8.5)
	No	44(65.67)	98(79.03)	1	1
Average sleeping hour	< 8 hours	12(17.91)	10(8.06)	2.4(1.01–6.11)	4.6(0.8–25.9)
	≥8 hours	55(82.09)	114(91.94)	1	1
Previous TB treatment	Yes	35(52.24)	15(12.1)	7.9(3.86–16.35)	11.8(2.9–47)**
	No	32(47.76)	109(87.9)	1	1
BMI (Kg/m2)	< 18.5	47(70.15)	48(38.71)	3.7(1.97–7.02)	4.5(1.2–16.8)*
	≥ 18.5	20(29.85)	76(61.29)	1	1
Contact history	Yes	12(17.91)	10(8.06)	2.4(1.01–6.11)	0.7(0.16–3.72)
	No	55(82.09)	114(91.94)	1	1
Type of TB	PTB	59(88.06)	74(59.68)	4.9(2.19–11.32)	5.1(1.33–19.8)*
	EPTB	8(11.94)	50(40.32)	1	1

Notes: *Statistically significant variable at p<0.05, **Statistically significant variable at p<0.01, 1= reference category.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; BMI, body mass index; EPTB, extra pulmonary tuberculosis; PTB, pulmonary tuberculosis.