Background: Multi-drug resistant tuberculosis (MDR-TB) is increasingly recognized as emerging infectious disease of public
health concern. Globally, 206030 people were diagnosed with MDR-TB in 2019, representing a 10% increase from 186883people
who had it in 2018. In Uganda, the prevalence of MDR among new TB cases is 4.4% and 17.7% among previously treated
TB cases.

Aim: To determine the risk factors associated with MDR-TB among tuberculosis patients in Gulu regional referral hospital.

Material and Methods: A cross-sectional analytical study using both quantitative and qualitative methods of data collection
and analysis was used. Data was collected from 384 TB patients using data extraction form and 6 Key informant interviews
conducted. Analysis using Pearson chi-square test was run.

Results: HIV positive patients were 2.6 times more likely to be infected with MDR-TB than HIV negative patients [AOR=2.6:
95% CI 1.34– 5.85: P=0.006]. Previously treated TB patients were 2.8 times more likely to be infected with MDR-TB than newly
diagnosed TB patients [AOR=2.8: 95% CI 1.33– 5.85: P=0.006]. Defaulting TB patients were 3.1 times more likely to be infected
with MDR-TB than the non-defaulting TB patients [AOR=3.1]

Conclusion: There is high prevalence of drug resistance among patients attending TB treatment at the facility.

Keywords: MDR-TB; tuberculosis; HIV; Gulu Regional Referral Hospital.