Multidrug-Resistance Tuberculosis (MDR-TB) is tuberculosis (TB) that is resistant to two first-line drugs; both isoniazid and rifampicin. Globally in 2015, there were an estimated 480, 000 new cases of multidrug-resistant TB. According to the anti-tuberculosis drug resistance survey conducted nationwide in Ethiopia in 2012 among 804 newly diagnosed TB cases 1.6 % were found to be infected with MDR-TB. The continuous challenge in the occurrence and management of Multidrug-Resistant Tuberculosis (MDR-TB) in the country in general and Nekemte Referral hospital in particular prompted this study which seeks-to investigate the risk factors for MDR-TB.Unmatched case control study design was conducted to identify the risk factors for multi-drug resistant tuberculosis among tuberculosis patients of Nekemte Referral Hospital. All MDR-TB (21 cases) and Non-MDR-TB (44 controls) patients’ registered from September 2016to August 2017 in this Hospital were included in the study. Face-to-face interview and Patient medical records review were used to collect the data. In bivariate analysis; variables which had P-value <=0.25 wereentered into multi-variate logistic regression model. P-value <0.05 taken as statistically significant. A total of 65 tuberculosis patients (21 cases and 44 controls) included in this study; response rate 100 %. Previous tuberculosis treatment (AOR = 0.975, 95 % CI = 0.957 – 0.994), history of defaulter (AOR=0.055, 95 % CI=0.008-0.391), history of Smoking (AOR=74.833, 95 % CI=1.563-36.248), number of rooms in the house (AOR=5.410,95 % CI=1.579-18.536) and presence of HIV/infection (AOR=0.232,95 % CI=0.065-0.823) were statistically significant predictors of having multidrug-resistance tuberculosis.History of- previous tuberculosis treatment; defaulter and smoking, number of rooms in the house, and presence of human immune virus infection were significant predictors in this study.Health education on adherence to anti-tuberculosis drugs and risky behaviorshould be given a special attention.

Keywords: Multidrug-resistant, Tuberculosis, Nekemte, Risk factor, Case-control.