The burden of drug resistant tuberculosis in a predominantly nomadic population in Uganda: a mixed methods study

Abstract Background Emergence of drug resistant tuberculosis (DR-TB) has aggravated the (TB) public health burden worldwide and especially in low income settings. We present findings from a predominantly nomadic population Karamoja, Uganda with high-TB (3500 new cases annually) sought to determine prevalence, patterns, factors associated DR-TB. Methods used mixed methods data collection. enrolled 6890 participants who were treated for programmatic setting between January 2015 April 2018. A cross sectional study matched case control conditional logistic regression robust standard errors respectively prevalence The qualitative included focus group discussions, in-depth interviews key informant interviews. Results overall DR-TB was 41/6890 (0.6%) 4/64,197 (0.1%) among 37/2693 (1.4%) previously TB patients respectively. resistance patterns observed region mainly rifampicin mono (68.3%) Multi Drug-Resistant Tuberculosis (31.7%). Factors independently previous treatment, adjusted odds ratio (aOR) 13.070 (95%CI 1.552–110.135) stock-outs aOR 0.027 0.002–0.364). lifestyle, substance use, congested homesteads poor worker attitudes great challenge effective treatment TB. Conclusion Despite having highest national incidence, Karamoja still prevalence. Previous stock outs Regular supply anti medications education may help stem disease this population.