title: Drug resistance patterns of Mycobacterium tuberculosis complex and associated factors among retreatment cases around Jimma, Southwest Ethiopia.
abstract: BACKGROUND
  Information on the pattern of drug resistant tuberculosis (TB) among re-treatment cases is crucial to develop appropriate control strategies. Therefore, we conducted this study to assess the drug resistance pattern of M. tuberculosis complex (MTBC) isolates and associated factors among re-treatment cases in Jimma area, Southwest Ethiopia.
  
  
  METHODS
  Health facility-based cross-sectional study was conducted between March 2012 and April 2013 in Jimma area, Southwest Ethiopia. We included 79 re-treatment cases selected conveniently. Socio demographic and clinical data were collected using structured questionnaire. Sputum sample processing, mycobacterial culture, isolation and drug susceptibility testing (DST) were done at Mycobacteriology Research Centre (MRC) of Jimma University. All data were registered and entered in to SPSS version 20. Crude odds ratio (COR) and adjusted odds ratios (AOR) were calculated. P-values less than 0.05 were considered statistically significant.
  
  
  RESULTS
  Seventy-nine re-treatment cases included in the study; 48 (60.8%) were males. Forty-seven (59.5%) study participants were from rural area with the mean age of 31.67 ± 10.02 SD. DST results were available for 70 MTBC isolates. Majority (58.6% (41/70)) isolates were resistant to at least one of the four first line drugs. The prevalence of multidrug-resistant TB (MDR-TB) was 31.4% (22/70). Place of residence (AOR = 3.44 (95 % CI: 1.12, 10.60), duration of illness (AOR = 3.00 (95 % CI: 1.17, 10.69) and frequency of prior TB therapy (AOR = 2.99, (95 % CI: 1.01, 8.86) were significant factors for any drug resistance. Moreover, history of treatment failure was found to be associated with MDR-TB (AOR = 3.43 (95 % CI: 1.14, 10.28).
  
  
  CONCLUSIONS
  The overall prevalence of MDR-TB among re-treatment cases around Jimma was high. The rate of MDR-TB was higher in patients with the history of anti-TB treatment failure. Timely identification and referral of patients with the history of treatment failure for culture and DST need to be strengthened.
authors.affiliation: Department of Medical Laboratory Science and Pathology, College of Health sciences, Jimma University, Jimma, Ethiopia. kedir.abdella@ju.edu.et.|Mycobacteriology Research Centre, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia. kedir.abdella@ju.edu.et.
authors.forename: Kedir
authors.initials: K
authors.lastname: Abdella
authors.affiliation: Department of Medical Laboratory Science and Pathology, College of Health sciences, Jimma University, Jimma, Ethiopia. ketema.abdissa@ju.edu.et.
authors.forename: Ketema
authors.initials: K
authors.lastname: Abdissa
authors.affiliation: Department of Medical Laboratory Science and Pathology, College of Health sciences, Jimma University, Jimma, Ethiopia. wakjira.kebede@ju.edu.et.
authors.forename: Wakjira
authors.initials: W
authors.lastname: Kebede
authors.affiliation: Department of Medical Laboratory Science and Pathology, College of Health sciences, Jimma University, Jimma, Ethiopia. gemeda.abebe@ju.edu.et.|Mycobacteriology Research Centre, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia. gemeda.abebe@ju.edu.et.
authors.forename: Gemeda
authors.initials: G
authors.lastname: Abebe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D016017:Odds Ratio; D015995:Prevalence; D019233:Retreatment; D012959:Socioeconomic Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents