Browsing by Author "Okware, Samuel"

Now showing 1 - 1 of 1
  • Thumbnail Image
    Item
    Retreatment TB is a risk factor for multidrug-resistant TB among people with HIV in rural eastern Uganda: A nested case-control study
    (Elsevier, 2025-09-12) Opolot, Godfrey; Olupot-Olupot, Peter; Okware, Samuel; Izudi, Jonathan
    Rationale People with human immunodeficiency virus (PWH) have an increased risk of multidrug-resistant TB (MDR-TB) compared to those without HIV. Objective To investigate the risk factors for MDR-TB among PWH in rural eastern Uganda. Methods We conducted a nested case–control study at Soroti Regional Referral Hospital in rural eastern Uganda. TB records from January 2017 to May 2024 were retrospectively reviewed to identify all PWH. MDR-TB was defined as resistance to at least both Isoniazid and Rifampicin following GeneXpert Mycobacterium TB and Rifampicin assay and culture-based drug-susceptible testing. Cases were PWH with MDR-TB, while controls were a random sample of PWH without MDR-TB, in a 1:3 ratio. Multivariable binary logistic regression was used to identify factors independently associated with being a case rather than a control. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported. Results We included 37 cases and 111 controls, and found retreatment TB was associated with being a case rather than a control (aOR 6.97; 95% CI 2.65–19.46). Male sex (aOR: 1.59; 95% CI: 0.67–3.93), clinically diagnosed pulmonary TB (aOR: 0.38; 95% CI: 0.10–1.23) or extrapulmonary TB (aOR: 0.37; 95% CI: 0.05–1.62), and recent anti-retroviral therapy initiation (aOR: 2.07; 95% CI: 0.83–5.28) were insignificantly associated with being a case. Conclusion This study showed that retreatment TB is associated with a higher likelihood of MDR-TB among PWH in a referral hospital in rural eastern Uganda. These findings underscore the need for intensified drug resistance surveillance and adherence support among PWH with prior TB treatment.