Magnitude Of Mycobacterium Tuberculosis Drug Resistance Pattern And Associated Factors Among Patients Referred To St. Pauls Hospital Millennium Medical College Addis Ababa Ethiopia.

Background: Tuberculosis (TB) is an infectious disease caused by strains belonging to thernMycobacterium tuberculosis complex. Mycobacterium tuberculosis (M. tuberculosis) remains onernof the most significant causes of death from an infectious agent and a major public health problemrnin the community. Drug development of drug resistance and its association with Humanrnimmunodeficiency virus (HIV) by far the major cause of the current increase in tuberculosisrninfection. Sub-Saharan Africa is endemic for both TB and HIV infection, and pulmonaryrntuberculosis (PTB) in the HIV-affected countries of eastern and southern Africa, such as Ethiopia,rnhas increased rapidly in the past decades. rnObjective:-To assess the magnitude of Mycobacterium tuberculosis, drug-resistance pattern ,and rnassociated factors among patients referred to St. Paul‘s Hospital Millennium Medical College,rnAddis Ababa, Ethiopia. rnMethods: A cross-sectional study was conducted at SPHMMC, Addis Ababa, Ethiopia from Jan tornJuly 2019. Socio-demographic data were collected by using structured questionnaire in face to facerninterview with patients. Sputum and non-sputum samples were also collected from 436 presumptivernTB cases. rnAll sputum specimens collected underwent digestion and decontamination using the NaOH-NALCrnmethod, whereas and extra pulmonary clinical samples were used directly without decontamination.rnAfter centrifugation sputum samples, the sediments were examined using Ziehl-Neelsen technique,rnanalyzed with Gene X-pert MTB/RIF assay, and culture using Lowenstein-Jensen (LJ) and positivernculture results were tested for drug resistance pattern using Line probe Assay (LPA). The collectedrndata was entered to EPI info 2002 version 3.32 after data editing and cleaning, exported to SPSSrnversion 23 for analysis.rnResults: The total of 436 respondents were included in the study, of this 223 (51%) were male. Thernmean ±SD age the participants was 38±17years. Regarding marital status, 238 (54.6%) participantsrnwere Julyried, and majority of the respondents 240(55%) urban resident, 214 (49 %) had monthlyrnincome 100-1000 Ethiopian Birr, 278 (63.8%) used carbohydrate as a usually monthly food item.rnOf the total, 374(85.8%) were diagnosed for pulmonary tuberculosis and 62(14.2%) were for extrapulmonaryrnrntuberculosis, and from all 130 (30-%) were HIV positive individuals. Out of the totalrnparticipants, the overall LJ culture confirmed Mycobacterium tuberculosis was, 27 (6.2%), andrnthree isolates were resistant for either INH or RIF drug, while two of them were MDR-TB based on rnline probe assays method. In a bivariate logistic regression analysis, having a previous TB-contactrnhistory (COR=3.1; 95 % CI: 1.1, 8.7; P=0.03), patient weight loss (COR=3.6; 95 % CI: 1.5-8.8;rnP=0.004), having pneumonia with chest X-ray diagnosis (COR=3; 95%CI:3, 33; P=0.02), andrnhaving CD4rn+ rnT-cells count 200-350/mmrn3rn of blood (COR=8.9; 95%CI:0.5, 0.9; p=0.049) werernsignificantly associated.rnConclusion: The magnitude of M. tuberculosis and MDR TB in this study highlights the need forrnfurther extended early case detection and managing MDR TB cases to minimize transmission andrnthe suffering of patients.

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