Predictors and Spatiotemporal Variation of Multi-drug-resistant Tubercu losis in the Upper West Region of Ghana: a 5-year Retrospective Study
Abstract
Introduction: Tuberculosis (TB) control and prevention in the Upper West Region of Ghana is challenged by the emergence of rifampicin and isoniazid resistance; multidrug-resistant tuberculosis (MDR-TB). The situation makes TB treatment less effective, prolonged, and expensive, and sometimes medicines used to treat MDR-TB result in unbearable side effects that deter patients from medication adherence. Therefore, this study aims to assess the Predictors of MDR-TB in the Upper West Region of Ghana from 2017 to 2021 to guide policy interventions in that Region.
Method: The study employed a cross-sectional design using secondary data. A purposive sampling technique was used to select three Districts with the highest number of confirmed TB cases and a simple random sampling technique was applied to sample a total of 318 confirmed TB cases from the three selected districts for the study. Descriptive statistics were used to estimate the median age of the cases, proportions, ratios, and logistic regression analysis to establish associations between the dependent and independent variables at a 95% confidence interval (CI).
Results: The multivariable logistic regression showed that smoking [AOR=6.42(95% CI=1.34–30.79)], TB retreatment [AOR=1.87 (95% CI=0.4-4.7)], and persons 70 years and above [AOR= 4.27 (95% CI=1.04–17.53) were independent predictors associated statistically with the prevalence of MDR-TB in the region. Generally, defaulting TB retreatment, age category, and smoking were identified as independent predictors with no hotspots of MDR-TB discovered within the study period.
Conclusion: Ghana Health Service and the National TB Control Program should regularly organize In-service training sessions for laboratory staff on DST and intensify health education on the predictors of MDR-TB in the region to reduce its prevalence further.
