# Prevalence of drug resistant tuberculosis and its associated factors among tuberculosis patients at wolkite health center in central Ethiopia

## TL;DR

This study examines the prevalence of drug-resistant tuberculosis and its risk factors among TB patients in a rural health center in central Ethiopia over three years.

## Contribution

The study provides new insights into MDR-TB prevalence and risk factors in a rural Ethiopian setting with limited prior data.

## Key findings

- Approximately 10.4% of TB cases were rifampicin-resistant (RR-TB) over three years.
- Previous TB history and HIV status were strongly associated with RR-TB.
- Young adults (18-34) had significantly lower risk of RR-TB compared to older adults.

## Abstract

Multidrug-resistant tuberculosis (MDR-TB) is increasingly recognized as a global public health challenge. Continuous monitoring of the prevalence of MDR-TB and its associated factors is crucial for the effective control and management of this disease. While alarming rates of MDR-TB have been reported in various parts of Ethiopia, data from rural health settings like Wolkite Health Center remain limited and underexplored. We aim to assess the prevalence of MDR-TB and its associated factors among tuberculosis (TB) patients at Wolkite Health Center. A three-year institution-based retrospective cross-sectional study was conducted at Wolkite Health Center, in the central Ethiopian region, Ethiopia. We have included all tuberculosis patients recorded in the tuberculosis (TB) registration form from February 4, 2021, to December 31, 2023. Data collection was carried out using a pretested structured data extraction checklist. Epidata version 3.1 and SPSS version 22 were used for data entry and analysis, respectively. Binary logistic regression was employed to assess the association between dependent and independent variables. A p-value of less than 0.05 was considered statistically significant. A total of 452 TB cases were included in our study. Of the total TB cases, around 10.4% (47/452) were rifampicin-resistant(RR) TB. Approximately 28.1% (127 out of 452) of the participants reported having been infected with TB at some point in their lifetime. The prevalence of RR TB remains relatively stable, with rates of 10.2% (15 out of 147 cases) in 2021, 8.7% (13 out of 149 cases) in 2022, and 12.2% (19 out of 156 cases) in 2023. Variables such as age, history of previous TB, and HIV status were found to be significantly associated with drug-resistant tuberculosis. Previous TB diseases were 5.1 times [AOR = 5.1, 95% CI: (2.5–10.1)], and HIV-positive TB cases were 6.6 times [AOR = 6.6, 95% CI: (3.5–9.7)] more likely to develop RR TB, whereas young adults aged 18 to 34 have a 95% lower risk of developing rifampicin-resistant tuberculosis compared to older adults over 60 years old [AOR = 0.05, 95% CI: (0.02–0.26)]. As a conclusion, over the three-year period from 2021 to 2023, there is no significant change in the prevalence of RR-TB. The significant association of previous TB treatment, HIV status, and age with drug resistance highlights the need for targeted interventions and comprehensive care strategies.

The online version contains supplementary material available at 10.1038/s41598-026-34986-9.