International Journal of Public Health Science (IJPHS) Vol. 13, No. 4, December 2024, pp. 1656~1663 ISSN: 2252-8806, DOI: 10.11591/ijphs.v13i4.24753  1656 Journal homepage: http://ijphs.iaescore.com Multidrug resistant tuberculosis risk factors in Makassar, Indonesia Siti Latifah Burhan 1 , Wahiduddin 1 , Ida Leida Maria 1 , M. Nadjib Bustan 1 , Lalu Muhammad Saleh 2 , Balqis 3 1 Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia 2 Department of Occupational Health and Safety, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia 3 Department of Health Administration and Policy, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia Article Info ABSTRACT Article history: Received Mar 7, 2024 Revised Apr 18, 2024 Accepted Apr 24, 2024 Multidrug resistant tuberculosis (MDR-TB) is a significant public health concern in Indonesia, resulting in substantial morbidity and mortality rates. This study aimed to quantify the impact of risk factors of MDR-TB. A case- control study was conducted at Makassar Community Lung Health Center (BBKPM) in Makassar City. A total of 132 respondents, 66 cases, and 66 controls have participated in the study. Data was analyzed using the Stata version 14 tool, odds ratio (OR), and multiple logistic regression. Multiple logistic regression analysis identified significant risk factors for the occurrence of MDR-TB include previous TB treatment (OR=8.46, 95% CI: 3.278-21.858), positive acid-fast bacilli (AFB) sputum (OR=6.40, 95% CI: 2.525-16.260), and adverse drug event (OR=3.45, 95% CI: 1.008-11.867). The probability of developing MDR-TB is 95.9% if there is previous TB treatment with cases of relapse/loss to follow-up/failed treatment, positive AFB sputum, and adverse drug event. The most dominant risk factor for the occurrence of MDR-TB is a previous TB treatment. We suggest that an efficient directly observed treatment shortcourse (DOTS) strategy, particularly in the management of adverse drug event, overseeing and supporting patients who have recovered from MDR-TB, involves the collaboration of MDR-TB healthcare professionals and patient supporters in the Yamali TB community, moving synergistically as an effort to MDR-TB control and prevention. Keywords: Acid-fast bacilli sputum Adverse drug event Multidrug resistant Previous tuberculosis treatment Tuberculosis This is an open access article under the CC BY-SA license. Corresponding Author: Siti Latifah Burhan Department of Epidemiology, Faculty of Public Health, Hasanuddin University Perintis Kemerdekaan KM 10, Tamalanrea, Makassar, South Sulawesi 90245, Indonesia Email: madelatifahburhan@gmail.com 1. INTRODUCTION Multidrug resistant tuberculosis (MDR-TB) remains a significant challenge in TB management and is a major public health issue in numerous countries worldwide. MDR-TB refers to a strain of Mycobacterium tuberculosis resistant to first-line anti-TB medications, specifically rifampicin (R) and isoniazid (H), which are highly effective against Mycobacterium tuberculosis bacteria. MDR-TB poses a new challenge in TB control initiatives due to its challenging diagnosis and high rates of therapeutic failure and mortality [1]. The World Health Organization (WHO) data from 2015-2020 indicates that the global estimate of MDR-TB cases remained consistent. In 2021, the predicted proportion of MDR-TB patients is 3.6%, which amounts to 450,000 cases. The current figure has risen compared to 2020, which stood at 3.1% (437,000 cases). This is believed to be connected to the coronavirus disease 2019 (COVID-19) epidemic,