Date of Conferral

2022

Degree

Ph.D.

School

Health Services

Advisor

Heidi Sato

Abstract

The emergence of multidrug-resistant tuberculosis (MDR-TB) jeopardizes the tremendous efforts in the fight against tuberculosis in Lesotho. To understand the occurrence of MDR-TB, it is important to identify the associated risk factors and how to address them. There is a literature gap on the sociodemographic risk factors associated with MDR-TB in Lesotho. This study assessed whether there is any significant association between age, employment, income, sex, education, place of residence and MDR-TB. The association between HIV and MDR-TB was also evaluated. Guided by the health belief model and social cognitive theory, a retrospective case-control study design and a proportionate stratified random sample were employed to gather primary data from 306 randomly selected participants from 12 TB clinics between March 2021 and February 2022. Confirmed TB patients who were 18 years of age or older were included in the study. Chi-square and multivariate logistic regression analysis were performed to identify the risk factors that moderate MDR-TB status. The results revealed that increased age beyond 18–26 years and income levels above $1,026.00 significantly decreased the odds of the risk of MDR-TB (OR = 0.8, 95% CI [ 0.673, 0.991], p = 0.040; OR = 0.5, 95% CI [0.222, 0.943] p = 0.034). Not having a caregiver was associated with increased odds of the risk of MDR-TB by 80% (OR = 1.8, 95% CI [1.039, 3.110], p = 0.036). The findings highlight the need for a public health campaign and education to enhance caregivers’ and young TB patients knowledge on infection prevention and control of MDR-TB. It is important to improve the socioeconomic drivers of MDR-TB among TB patients by targeting those that are poor and vulnerable.

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