Abstract:
Background: Tuberculosis remains one of the most persistent and deadly infectious diseases
worldwide, despite decades of global public health efforts aimed at its control and eradication.
While the disease itself is both preventable and treatable, the emergence and spread of drug
resistant forms of tuberculosis have complicated these efforts and raise global concern.
Objective: To determine the prevalence of drug-resistant tuberculosis and its associated factors
among tuberculosis patients in Galkayo General Hospital, Puntland Somalia, 2020-2024.
Methodology: A facility-based retrospective cross-sectional study was carried out at Galkayo
General Hospital in Puntland, Somalia, from January 2020 to December 2024. Data were
collected through a structured review of patient medical records using a standardized
abstraction tool. A total of 422 records were randomly selected. The data were coded, entered
into Epi Info, and exported to STATA version 17 for analysis. Descriptive statistics were
summarized with tables, graphs, and charts. Factors associated with drug-resistant tuberculosis
were examined using bivariable and multivariable logistic regression, with statistical
significance determined at 95% confidence intervals and a p-value < 0.05.
Results: From a total of 410 patients included in this study, the prevalence of drug-resistant
tuberculosis in the study population was 9.02% (95% CI: 6.23%–11.81%), reflecting a notable
burden. Multivariable logistic regression showed that patients with prior contact with a
tuberculosis case (AOR = 2.43; 95% CI: 1.13–5.21), those with a previous history of
tuberculosis (AOR = 3.63; 95% CI: 1.72–7.67), and treatment failure cases (AOR = 9.03; 95%
CI: 2.03–40.12) had statistically significant association with drug-resistant tuberculosis.
Conclusion: This study revealed the high burden of drug-resistant tuberculosis, identifying
prior contact with tuberculosis patients, previous treatment, and treatment failure as major
contributors. Reducing drug resistance requires early detection, strong treatment adherence,
and integrated care. Key actions include better contact tracing, close monitoring of treatment
outcomes, and linking tuberculosis and HIV services. Training healthcare workers and raising
community awareness can further promote early health-seeking and strengthen efforts to
control the disease.
