Nakafeero Simbwa, BrendaKatamba, AchillesKatana, Elizabeth B.Laker, Eva A. O.Nabatanzi, SandraSendaula, EmmanuelOpio, DenisIctho, JerryLochoro, PeterKaramagi, Charles A.Kalyango, Joan N.Worodria, William2022-02-032022-02-032021Simbwa, B. N., Katamba, A., Katana, E. B., Laker, E. A., Nabatanzi, S., Sendaula, E., ... & Worodria, W. (2021). The burden of drug resistant tuberculosis in a predominantly nomadic population in Uganda: a mixed methods study. BMC Infectious Diseases, 21(1), 1-11. https://doi.org/10.1186/s12879-021-06675-7https://doi.org/10.1186/s12879-021-06675-7https://nru.uncst.go.ug/xmlui/handle/123456789/1859Emergence of drug resistant tuberculosis (DR-TB) has aggravated the tuberculosis (TB) public health burden worldwide and especially in low income settings. We present findings from a predominantly nomadic population in Karamoja, Uganda with a high-TB burden (3500 new cases annually) and sought to determine the prevalence, patterns, factors associated with DR-TB. Methods: We used mixed methods of data collection. We enrolled 6890 participants who were treated for tuberculosis in a programmatic setting between January 2015 and April 2018. A cross sectional study and a matched case control study with conditional logistic regression and robust standard errors respectively were used to the determine prevalence and factors associated with DR-TB. The qualitative methods included focus group discussions, in-depth interviews and key informant interviews. Results: The overall prevalence of DR-TB was 41/6890 (0.6%) with 4/64,197 (0.1%) among the new and 37/2693 (1.4%) among the previously treated TB patients respectively. The drug resistance patterns observed in the region were mainly rifampicin mono resistant (68.3%) and Multi Drug-Resistant Tuberculosis (31.7%). Factors independently associated with DR-TB were previous TB treatment, adjusted odds ratio (aOR) 13.070 (95%CI 1.552–110.135) and drug stock-outs aOR 0.027 (95%CI 0.002–0.364). The nomadic lifestyle, substance use, congested homesteads and poor health worker attitudes were a great challenge to effective treatment of TB. Conclusion: Despite having the highest national TB incidence, Karamoja still has a low DR-TB prevalence. Previous TB treatment and drug stock outs were associated with DR-TB. Regular supply of anti TB medications and health education may help to stem the burden of TB disease in this nomadic population.enDrug resistant TuberculosisNomadicUgandaKaramojaGene-XpertLow prevalenceAlcoholDrug stock outStigmaArticle