Determinants of Drug Resistant Tuberculosis Among Tuberculosis Patients on Treatment in Gedeo Zone Public Healthcare Facilities, Southern Ethiopia, 2025. Unmatched case‒control study.

Introduction: Drug-resistant tuberculosis (DR-TB) is a form of tuberculosis caused by Mycobacterium tuberculosis strains that do not respond to standard anti-TB drugs. Ethiopia ranked among the top 30 countries burdened by DR-TB in the world. Although drug-resistant tuberculosis is a growing public health concern in the Gedeo Zone, determinants of DR-TB are still inadequately explored, as few studies have been undertaken in this area. Therefore, this study aimed to assess the determinants of drug-resistant tuberculosis among TB patients receivingtreatment. Objectives : To assess the determinants of drug-resistant tuberculosis among TB patients receiving treatment in Gedeo Zone public healthcare facilities, southern Ethiopia, 2025 Methods : An institution-based unmatched case‒control study was conducted from July 21--August 19, 2025, with a total of 177 participants (59 cases and 118 controls) who attended public healthcare facilities in the Gedeo zone. A simple random sampling technique was used to select a study participant. The data were collected with the Kobo Toolbox and then exported to SPSS version 27 for analysis. Associations between dependent and independent variables were assessed via binary logistic regression. At the 95% CI, in bivariable analysis, a p value of <0.25 was used to select candidate variables for multivariable analysis. In the multivariable analysis, a p value of less than 0.05 was considered statistically significant. Result: In this study, 177 participants (59 cases and 118 controls) were enrolled, resulting in a 100% response rate. This study revealed that five factors were significantly associated with DR-TB in this study area: lack of formal education (AOR = 3.37, 95% CI: 1.09–10.42), urban residence (AOR = 2.54, 95% CI: 1.07–6.03), previous TB treatment history (AOR = 3.34, 95% CI: 1.57–7.09), counselling on DR-TB (AOR = 0.28, 95% CI: 0.10–0.78), and social stigma (AOR = 3.27, 95% CI: 1.56–6.84). Conclusion: Lack of formal education, urban residence, previous TB treatment history, counselling and social stigma was found to be determinants of DR-TB. Effective DR-TB control interventions focused on the above determinants need to be implemented.