{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T16:57:40Z","timestamp":1774285060942,"version":"3.50.1"},"reference-count":36,"publisher":"Pan African Medical Journal","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pan Afr Med J"],"abstract":"<jats:p>Introduction: multidrug-resistant tuberculosis (MDR-TB) defined as resistance to isoniazid and rifampicin, has become a major threat to the control of TB across the globe. This study aimed to determine the risk factors and treatment outcomes of Drug-resistant tuberculosis (DR-TB) patients attending Ndola Teaching Hospital (NTH) in Ndola, Zambia.\n\n \n\nMethods: we conducted a case control study among DR-TB patients treated at NTH from 2018 - 2020. Medical records of selected MDR-TB cases and drug susceptible TB controls were included. Treatment outcomes of MDR-TB patients were recorded. The multivariable logistic regression was used to evaluate associations between risk factors and MDR-TB infection. Odds ratios and their 95% confidence intervals were reported.\n\n \n\nResults: the mean age for the study was 36.67\u00b19.94, and males were the majority 156(70.9%). Those with HIV were 123(55.9%), and contact with DR-TB patients were 61(27.7%). A total of 110 cases and 110 controls were selected for this study. The multivariable logistic regression model indicated a strong association between a family size of 1-5 and occurrence of MDR-TB (aOR (adjusted odds ratio): 1.44, 95% CI (confidence interval), 0.74-2.79; p=0.028*). There was also a strong association between contact with TB patient and MDR-TB (aOR: 1.67, 95% CI 0.56-4.92, p=0.033*). The analysis indicated that living in the rural area had a negative association with MDR-TB development (aOR: 0.42, 95% CI 0.19- 0.91, p=0.025*). There was also a negative association between history of previous treatment and developing MDR-TB (aOR: 0.32, 95% CI 0.17-0.61, p&lt;0.001*), as well as that between contact with MDR-TB patient and MDR-TB development (aOR: 0.50, 95% CI 0.16-1.52, p=0.010*). The study further found that of the 110 MDR-TB patients treated, 73.6% had a successful treatment outcome, and 26.4% had an unsuccessful treatment outcome.\n\n \n\nConclusion: the study found that smaller family size and contact with TB patients were significant risk factors for developing MDR-TB, while living in rural areas, having a history of previous TB treatment, and contact with MDR-TB patients were negatively associated with its occurrence. A notable proportion of unsuccessful treatment outcome of some cases underscores the need for strengthened patient-centered care, adherence support, and equitable access to healthcare across both rural and urban settings.<\/jats:p>","DOI":"10.11604\/pamj.2026.53.84.50004","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T16:02:40Z","timestamp":1774281760000},"source":"Crossref","is-referenced-by-count":0,"title":["Risk factors and treatment outcomes of drug-resistant tuberculosis among patients attending Ndola teaching hospital in Ndola, Zambia: a retrospective case control study"],"prefix":"10.11604","author":[{"given":"Ricardo","family":"Mckees","sequence":"first","affiliation":[{"name":"Department of Public Health, Copperbelt University, Michael Chilufya Sata School of Medicine, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Gwasupika","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, National Health Research Training Institute, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9707-2673","authenticated-orcid":false,"given":"Ruth Lindizyani","family":"Mfune","sequence":"additional","affiliation":[{"name":"Department of Public Health, Copperbelt University, Michael Chilufya Sata School of Medicine, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clyde Moono","family":"Hakayuwa","sequence":"additional","affiliation":[{"name":"Department of Public Health, Copperbelt University, Michael Chilufya Sata School of Medicine, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias","family":"Tembo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, National Health Research Training Institute, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chapline Shike","family":"Kalasa","sequence":"additional","affiliation":[{"name":"Department of Public Health, Copperbelt University, Michael Chilufya Sata School of Medicine, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Mwabafu","sequence":"additional","affiliation":[{"name":"Chest Diseases Laboratory, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngula","family":"Monde","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, National Health Research Training Institute, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6798-2799","authenticated-orcid":false,"given":"Imukusi","family":"Mutanekelwa","sequence":"additional","affiliation":[{"name":"Department of Public Health, Copperbelt University, Michael Chilufya Sata School of Medicine, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Namaunga","family":"Kasumu","sequence":"additional","affiliation":[{"name":"Department of Basic Sciences,Copperbelt University, Michael Chilufya Sata School of Medicine, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maisa","family":"Kasanga","sequence":"additional","affiliation":[{"name":"Pathology and Microbiology Laboratory, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Comfort","family":"Asante","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, National Health Research Training Institute, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1692-8981","authenticated-orcid":false,"given":"Steward","family":"Mudenda","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Zambia, School of Health Sciences, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9490-5609","authenticated-orcid":false,"given":"Victor","family":"Daka","sequence":"additional","affiliation":[{"name":"Department of Public Health, Copperbelt University, Michael Chilufya Sata School of Medicine, Ndola, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4870","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"ref0","unstructured":"World Health Organizatio. Global Tuberculosis Report 2024. Geneva; WHO. 2024."},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Canetti D, Riccardi N, Martini M, Villa S, Di Biagio A, Codecasa L et al. HIV and tuberculosis: a historical perspective on conflicts and challenges. Tuberculosis. 2020 May 1;122:101921. Google Scholar","DOI":"10.1016\/j.tube.2020.101921"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Vanino E, Granozzi B, Akkerman OW, Munoz-Torrico M, Palmieri F, Seaworth B et al. Update of drug-resistant tuberculosis treatment guidelines: A turning point. Int J Infect Dis. 2023 May:130 Suppl 1:S12-S15. PubMed | Google Scholar","DOI":"10.1016\/j.ijid.2023.03.013"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Naidoo K, Perumal R, Cox H, Mathema B, Loveday M, Ismail N et al.The epidemiology, transmission, diagnosis, and management of drug-resistant tuberculosis-lessons from the South African experience. Lancet Infect Dis. 2024 Sep;24(9):e559-e575. PubMed | Google Scholar","DOI":"10.1016\/S1473-3099(24)00144-0"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Ismail N, Ismail F, Omar SV, Blows L, Gardee Y, Koornhof H et al. Drug resistant tuberculosis in Africa: current status, gaps and opportunities. Afr J Lab Med. 2018 Dec 6;7(2):781. PubMed | Google Scholar","DOI":"10.4102\/ajlm.v7i2.781"},{"key":"ref5","unstructured":"Balate DA, Manhi\u00e7a I, Macuacua B, Jos\u00e9 B, Banze D, Langa JC et al. Evaluation of the multidrug-resistant tuberculosis surveillance system in Maputo City, Mozambique in the period 2017-2018, Pan Afr Med J. 2022 Apr 7:41:284. PubMed | Google Scholar"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Kapata N, Grobusch MP, Chongwe G, Chanda-Kapata P, Ngosa W, Tembo M et al. Outcomes of multidrug-resistant tuberculosis in Zambia: a cohort analysis. Infection. 2017 Dec;45(6):831-839. PubMed | Google Scholar","DOI":"10.1007\/s15010-017-1054-8"},{"key":"ref7","unstructured":"Zambia Statistics Agency. 2022 Census of Population and Housing Preliminary Report. ZSA. 2022."},{"key":"ref8","unstructured":"World Health Organization. Definitions and reporting framework for tuberculosis \u2013 2013 revision: updated December 2014 and January 2020. Accessed on Sept 1, 2025."},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Chanda E. The clinical profile and outcomes of drug resistant tuberculosis in Central Province of Zambia. BMC Infect Dis. 2024 Apr 1;24(1):364. PubMed | Google Scholar","DOI":"10.1186\/s12879-024-09238-8"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Chisompola D, Mulenga C, Tembo K, Mukuma N, Chinyante E. Trends and Prevalence of Rifampicin-Resistant Tuberculosis at Ndola Teaching Hospital, Zambia (2020-s2022). Medical Journal of Zambia. 2025 Jun 2;52(3):346-57. Google Scholar","DOI":"10.55320\/mjz.52.3.650"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Adane A, Damena M, Weldegebreal F, Mohammed H. Prevalence and Associated Factors of Tuberculosis among Adult Household Contacts of Smear Positive Pulmonary Tuberculosis Patients Treated in Public Health Facilities of Haramaya District, Oromia Region, Eastern Ethiopia. Tuberc Res Treat. 2020 Jan 27:2020:6738532. PubMed | Google Scholar","DOI":"10.1155\/2020\/6738532"},{"key":"ref12","unstructured":"Vandana Batra, Jocelyn Y Ang. Pediatric Tuberculosis: Overview of Tuberculosis, TB Risk Factors, Mechanism of TB Infection. Accessed on Sept 1, 2025."},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Fares A. Seasonality of tuberculosis. J Glob Infect Dis. 2011 Jan;3(1):46-55. PubMed | Google Scholar","DOI":"10.4103\/0974-777X.77296"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Afshari M, Dehmardeh A, Hoseini A, Moosazadeh M. Tuberculosis infection among children under six in contact with smear positive cases: a study in a hyper endemic area of Iran. J Clin Tuberc Other Mycobact Dis. 2023 Jan 18:30:100347. PubMed | Google Scholar","DOI":"10.1016\/j.jctube.2023.100347"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Wanyeki I, Olson S, Brassard P, Menzies D, Ross N, Behr M. Dwellings, crowding, and tuberculosis in Montreal. Soc Sci Med . 2006 Jul;63(2):501-11. PubMed | Google Scholar","DOI":"10.1016\/j.socscimed.2005.12.015"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"D. Gobena, G. Ameya, K. Haile, G. Abreha, Y. Worku, and T. Debela. Predictor of multidrug resistant tuberculosis in southwestern part of Ethiopia: A case control study.\u00b4. Ann Clin Microbiol Antimicrob. 2018 Jul 3;17(1):30. PubMed | Google Scholar","DOI":"10.1186\/s12941-018-0283-8"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Beyanga M, Kidenya BR, Gerwing-Adima L, Ochodo E, Mshana SE, Kasang C. Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania. BMC Infect Dis. 2018 Mar 6;18(1):110. PubMed | Google Scholar","DOI":"10.1186\/s12879-018-3036-6"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Seid G, Alemu A, Dagne B, Sinshaw W, Gumi B. Tuberculosis in household contacts of tuberculosis patients in sub-Saharan African countries: a systematic review and meta-analysis. J Clin Tuberc Other Mycobact Dis. 2022 Nov 12:29:100337. PubMed | Google Scholar","DOI":"10.1016\/j.jctube.2022.100337"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Li M, Lu L, Guo M, Jiang Q, Xia L, Jiang Y. Discrepancy in the transmissibility of multidrug-resistant mycobacterium tuberculosis in urban and rural areas in China. Emerg Microbes Infect. 2023 Dec;12(1):2192301. PubMed | Google Scholar","DOI":"10.1080\/22221751.2023.2192301"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Epidemiological characteristics and risk factors of multidrug-resistant tuberculosis in Luoyang China. Front Public Health. 2023 May 9:11:1117101. PubMed | Google Scholar","DOI":"10.3389\/fpubh.2023.1117101"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Mutembo S, Mutanga JN, Musokotwane K, Kanene C, Dobbin K, Yao X. Urban-rural disparities in treatment outcomes among recurrent TB cases in Southern Province, Zambia. BMC Infect Dis. 2019 Dec 30;19(1):1087. PubMed | Google Scholar","DOI":"10.1186\/s12879-019-4709-5"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Desissa F, Workineh T, Beyene T. Risk factors for the occurrence of multidrug-resistant tuberculosis among patients undergoing multidrug-resistant tuberculosis treatment in East Shoa, Ethiopia\u00b4.,BMC Public Health. 2018 Apr 2;18(1):422. PubMed | Google Scholar","DOI":"10.1186\/s12889-018-5371-3"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Admassu F, Abera E, Gizachew A, Sedoro T, Gari T. Risk factors of multidrug resistant tuberculosis among patients with tuberculosis at selected multidrug resistance treatment initiative centres in southern Ethiopia: a case-control study. BMJ Open. 2023 Jan 13;13(1):e061836. PubMed | Google Scholar","DOI":"10.1136\/bmjopen-2022-061836"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Monde N, Munyeme M, Malama S. A review of tuberculosis in Ndola District of Zambia. JTR. 2016;4(01):1. Google Scholar","DOI":"10.4236\/jtr.2016.41001"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Shah NS, Yuen CM, Heo M, Tolman AW, Becerra MC. Yield of contact investigations in households of patients with drug-resistant tuberculosis: systematic review and meta-analysis. Clin Infect Dis. 2014 Feb;58(3):381-91. PubMed | Google Scholar","DOI":"10.1093\/cid\/cit643"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Ahmed S, Lotia-Farrukh I, Khan PY, Adnan S, Sodho JS, Bano S. High prevalence of multidrug-resistant TB among household contacts in a high burden setting. Int J Tuberc Lung Dis. 2023 Aug 1;27(8):646-648. PubMed | Google Scholar","DOI":"10.5588\/ijtld.23.0123"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Shadrach BJ, Kumar S, Deokar K, Singh GV, Hariharan, Goel R. A study of multidrug resistant tuberculosis among symptomatic household contacts of MDR-TB patients. Indian J Tuberc. 2021 Jan;68(1):25-31. PubMed | Google Scholar","DOI":"10.1016\/j.ijtb.2020.09.030"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Satti H, McLaughlin MM, Seung KJ, Becerra MC, Keshavjee S. High risk of drug-resistant tuberculosis when first-line therapy fails in a high HIV prevalence setting. Int J Tuberc Lung Dis. 2013 Jan;17(1):100-6. PubMed | Google Scholar","DOI":"10.5588\/ijtld.12.0344"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Chilyabanyama R, Kamanga N, Mwandia JN. Factors associated with tuberculosis treatment outcomes among TB patients aged 15 years and older at chawama level one hospital in Lusaka, Zambia. Glob Public Health. 2024 Jan;19(1):2307979. PubMed | Google Scholar","DOI":"10.1080\/17441692.2024.2307979"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Daka S, Matsuoka Y, Ota M, Hirao S, Phiri A. Causes of pre-treatment loss to follow-up in patients with TB. Public Health Action. 2022 Dec 21;12(4):148-152. PubMed | Google Scholar","DOI":"10.5588\/pha.22.0051"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Mishra P, Sharma RK, Yadav R, Rao VG, Nigam S, Lingala MA. Reasons for loss to follow-up (LTFU) of pulmonary TB (PTB) patients: a qualitative study among Saharia, a particularly vulnerable tribal group of Madhya Pradesh, India. PLoS One. 2021 Dec 23;16(12):e0261152. PubMed | Google Scholar","DOI":"10.1371\/journal.pone.0261152"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Dangisso MH, Woldesemayat EM, Datiko DG, Lindtj\u00f8rn B. Long-term outcome of smear-positive tuberculosis patients after initiation and completion of treatment: A ten-year retrospective cohort study\u00b4,PLoS One. 2018 Mar 12;13(3):e0193396. PubMed | Google Scholar","DOI":"10.1371\/journal.pone.0193396"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"The Global fund. Zambia. Accessed on Sept 01, 2025.","DOI":"10.5089\/9798229005036.019"},{"key":"ref34","unstructured":"World Health Organization.Department for HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections. Accessed on Sept 01, 2025."},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"SDG 3: Ensure Healthy Lives and Promote Well-Being for All at All Ages. Accessed on Sept 01, 2025.","DOI":"10.1007\/978-981-95-0317-9_5"}],"container-title":["Pan African Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T16:02:53Z","timestamp":1774281773000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.panafrican-med-journal.com\/content\/article\/53\/84\/full\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":36,"URL":"https:\/\/doi.org\/10.11604\/pamj.2026.53.84.50004","relation":{},"ISSN":["1937-8688"],"issn-type":[{"value":"1937-8688","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,13]]},"article-number":"50004"}}