article · PLoS ONE
A facility-based cross-sectional study conducted between July 2018 and August 2019 investigated the prevalence and drivers of multidrug-resistant tuberculosis in the Tigray Region of Ethiopia. Sputum samples and clinical, sociodemographic, and behavioural data were evaluated from 300 patients aged 15 and older who tested positive via GeneXpert and were not yet receiving treatment. Laboratory drug susceptibility testing was conducted using line probe assays. The overall proportion of multidrug-resistant tuberculosis was 16.7 percent, comprising 11.6 percent of new cases and 32.7 percent of previously treated patients. In addition, 5.3 percent of the resistant isolates showed pre-extensively drug-resistant strains, and 21.1 percent of patients had concurrent HIV infection. Statistical analysis demonstrated that a previous history of tuberculosis treatment, cigarette smoking, and suffering from intermittent fever were strongly linked to the condition. Addressing programme performance and implementing priority interventions are critical.
Multidrug-resistant tuberculosis poses a major threat to public health control efforts globally. Finding substantial resistance rates among newly diagnosed patients indicates active community transmission rather than resistance developing solely during ineffective therapy. Identifying local risk factors, such as smoking and prior treatment history, enables health authorities to target interventions, improve patient management, and mitigate the spread of highly resistant bacterial strains.
The abstract does not indicate an application pathway or commercial technology. The findings provide epidemiological evidence intended for public health authorities and tuberculosis control programmes rather than commercial products. Any potential application would involve informing clinical guidelines, diagnostic prioritisation, and regional disease management protocols rather than market-ready technical solutions.
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BACKGROUND: Tuberculosis (TB) is among the top 10 causes of mortality and the first killer among infectious diseases worldwide. One of the factors fuelling the TB epidemic is the global rise of multidrug resistant TB (MDR-TB). The aim of this study was to determine the magnitude and factors associated with MDR-TB in the Tigray Region, Ethiopia. METHOD: This study employed a facility-based cross-sectional study design, which was conducted between July 2018 and August 2019. The inclusion criteria for the study participants were GeneXpert-positive who were not under treatment for TB, PTB patients' ≥15 years of age and who provided written informed consent. A total of 300 participants were enrolled in the study, with a structured questionnaire used to collect data on clinical, sociodemographic and behavioral factors. Sputum samples were collected and processed for acid-fast bacilli staining, culture and drug susceptibility testing. Drug susceptibility testing was performed using a line probe assay. Logistic regression was used to analyze associations between outcome and predictor variables. RESULTS: The overall proportion of MDR-TB was 16.7% (11.6% and 32.7% for new and previously treated patients, respectively). Of the total MDR-TB isolates, 5.3% were pre-XDR-TB. The proportion of MDR-TB/HIV co-infection was 21.1%. A previous history of TB treatment AOR 3.75; 95% CI (0.7-2.24), cigarette smoking AOR 6.09; CI (1.65-2.50) and patients who had an intermittent fever (AOR = 2.54, 95% CI = 1.21-5.4) were strongly associated with MDR-TB development. CONCLUSIONS: The magnitude of MDR-TB observed among new and previously treated patients is very alarming, which calls for an urgent need for intervention. The high proportion of MDR-TB among newly diagnosed cases indicates ongoing transmission, which suggests the need for enhanced TB control program performance to interrupt transmission. The increased proportion of MDR-TB among previously treated cases indicates a need for better patient management to prevent the evolution of drug resistance. Assessing the TB control program performance gaps and an optimal implementation of the WHO recommended priority actions for the management of drug-resistant TB, is imperative to help reduce the current high MDR-TB burden in the study region.
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DOI: 10.1371/journal.pone.0236362
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