Factors associated with drug resistant tuberculosis among tuberculosis patients of selected health care facilities of Bangladesh: A Case-Control study

The prevalence of tuberculosis (TB) is reducing in Bangladesh, but the emergence of drug resistant tuberculosis make the TB control effort more challenging and questionable. The present study aimed to identify the socio-demographic, behavioral and clinical risk factors for developing DR-TB.The study was an unmatched case-control study conducted in the four referral TB hospital and eight Upazilla health complex located in the Mymensingh, Netrakona, Tangail and Dhaka district of Bangladesh from  August, 2018 to January, 2019. Drug resistant tuberculosis (DR-TB) patients were considered as cases and drug susceptible TB patients (DS-TB) were considered as controls. A total of 184 respondents, 92 cases and 92 controls were enrolled in the study from both the hospital and community. Face to face interview and hospital record review was done for data collection by structured questionnaire. Multiple logistic regression model was used to determine the associations between available factors and DR-TB and the results were presented by odds ratios (ORs) with their 95% confidence intervals (CI).History of previous TB treatment recognized as highly significant independent factor for acquiring DR-TB (OR 10.069; 95% CI 4.759-21.305).Patients those have not attended school (OR 3.123;95% CI 1.112-8.771), unemployed (OR 2.956; 95% CI 1.374-6.360), had family history of tuberculosis (OR 2.870; 95% CI 1.017-8.105) were also identified as significant associated factors. BCG vaccination was found protective from DR-TB (OR 0.419; 95% CI 0.205-0.855). Policy makers should be prioritizes and considers all identified associated factors in their planning and decision making to reduce the burden of DR-TB in the country.