Quality Of Care And Associated Factors Among Patients With Multi-Drug Resistant Tuberculosis Receving Treatment In Alert Hospital Addis Ababa,Ethiopia, 2020

Background Multi-drug resistant tuberculosis (MDR-TB) remains a critical public health challenge worldwide and in Ethiopia, where treatment success largely depends on the quality of care. Assessing the quality of MDR-TB services and identifying associated factors is vital for improving treatment outcomes and controlling transmission. Objective To assess the quality of MDR-TB care and associated factors among patients receiving treatment at ALERT Hospital, Addis Ababa, Ethiopia, in 2020. Methods An institution-based cross-sectional study was conducted among 294 MDR-TB patients selected using systematic random sampling. Data were collected through structured questionnaires and patient records. Descriptive statistics were used to summarize socio-demographic characteristics, knowledge, and care-related variables. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with quality of care at a 95% confidence level. Results Of 294 respondents (96% response rate), the majority were female (72.8%) and aged 51–68 years (29.9%). Knowledge about MDR-TB was generally low; only 20.1% knew its meaning, and 19.4% recognized it as a curable disease. Most respondents (64.8%) reported not being informed about drug side effects, 68.0% were not told about sputum test requirements, and 73.1% were unaware of treatment duration. Shortages of drugs and laboratory reagents were reported by 80.4%, and MDR-TB treatment cards were often partially (49.8%) or not filled (34.7%). Adherence to directly observed treatment (DOT) was poor, with transportation (51.8%) and stigma (26.9%) cited as major barriers. In multivariable analysis, male patients were more likely to receive quality care [AOR = 2.06; 95% CI: 1.29–3.29], while screening at inpatient units was significantly associated with reduced likelihood of receiving quality care [AOR = 0.53; 95% CI: 0.33–0.84]. Conclusion The study revealed suboptimal quality of MDR-TB care characterized by poor patient knowledge, inadequate provider–patient communication, frequent drug shortages, and incomplete patient records. Improving patient education, strengthening provider communication, ensuring uninterrupted drug and reagent supply, and adopting patient-centered approaches are essential to enhance MDR-TB care and treatment outcomes.