Risk factors for multidrug-resistant tuberculosis in the Central African Republic: A case-control study

The emergence and spread of multidrug-resistant tuberculosis (MDR-TB) presents a challenge to the "End TB by 2035" strategy. This study aimed to identify the risk factors associated with MDR-TB in patients admitted to the pneumo-physiology clinic of the National University Hospital of Bangui in Central African Republic. This was a “retrospective” chart review study. Cases were represented by patients more than 18 years of age treated for MDR-TB and controls were patients with “at least rifampicin-susceptible” TB treated "with first-line anti-TB regimen" and who at the end of treatment were declared cured. The status of “cured” was exclusively applicable to non-MDR TB. Risk factors associated with MDR-TB were identified by multivariate analysis. We included 70 cases and 140 controls. The median age was 35 years, IQR (22;46 years). The main factors associated with the occurrence of MDR-TB in multivariate analysis were male gender (0 R = 3.02 [1.89 - 3.99], p = 0.001), residence in a peri-urban/urban area (0 R = 3.06 [2.21 - 4.01], p = 0.002), history of previous TB treatment (0 R= 3.99 [2.77 - 4.25], p < 0.001) and the presence of multidrug-resistant TB in the family (0 R=1.86 [1.27 - 2.45], p = 0.021). The emergence of MDR-TB can be reduced by implementing appropriate strategies, such as preventive therapy in contacts of MDR-TB patients and detecting and appropriately treating MDR-TB patients to prevent further spread of infection. The datasets used and analysed during the current study available from the corresponding author on reasonable request. The datasets generated and/or analysed during the current study are not publicly available due to the promise made to medical staff of the hospital to keep the data confidential when they are questioned, but are available from the corresponding author on reasonable request. Keywords