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Background: Multidrug-resistant tuberculosis (MDR-TB) has become a major public health problem and obstacle to global TB control. MDR-TB is associated with higher case fatality rates, especially among HIV-infected patients, and is much more difficult and costlier to treat than drug susceptible TB. Namibia is the country with the fourth highest TB burden in the world. The incidence rate in 2015 was 651/100 000. Multidrug-resistant tuberculosis (MDR-TB) has become a major public health problem, especially in developing countries, where the MDR-TB burden is the highest. In Namibia, among the regions highly affected by MDR-TB, Ohangwena region is facing many challenges. A recent study has demonstrated that the magnitude of the problem by numbers, about 40 per cent of patients admitted to the Katutura State Hospital’s TB unit and 30 per cent of patients who commenced treatment at the Engela District Hospital in the Ohangwena Region are Angolan nationals. Objectives: To determine geospatial Multidrug-resistant and extensively drug-resistant Tuberculosis Distribution in Angola and Namibia; To investigate the impact of geospatial distribution on Multidrugresistant and extensively drug-resistant Tuberculosis. Methods: this is a retrospective cohort study that will be performed on all cases of Multidrug-resistant and extensively drug-resistant Tuberculosis with confirmed laboratory test in Engela District Hospital between January 2013 and December 2017. Geospatial data will be used to illustrate all hypotheses. Conclusion: this study could be crucial on its genre to establish different gaps between Angolan and Namibian in the management of MDR-TB in Engela district hospital. Problem of statement TB has been recognized as a significant public health problem in Namibia since its independence in 1990 and the National TB Control Programme (NTCP) has continually revised its TB control guidelines, in order incorporate updated WHO recommendations and address DR-TB. Few years ago, multidrugresistant tuberculosis (MDR-TB) has become a major public health problem in Namibia. The emergence and controlling the spread of MDR-TB begins with its timely diagnosis (Sagwa 2016). TB can be cured with effective treatment, but with ineffective treatment, MDR TB could develop with grave consequences for the patient, his/her family and community as well as for the health care services. MDR TB develops when TB treatment is ineffective and/or inconsistent. A recent survey conducted in Namibia has shown that drug resistance among TB patients is increasing. Among Namibian regions affected my MDR-TB, Ohangwena Region is highly concerned. In fact, Ohangwena region is among the region that contributed the most patients with 12% (MOHSS 2016). A recent report has demonstrating that the magnitude of Angolan nationals admitted in Namibia is high in this region (Lelamobile 2015). In fact, 40 per cent of patients admitted to the Katutura State Hospital’s TB unit and 30 per cent of patients who commenced treatment at the Engela District Hospital in the Ohangwena Region are Angolan nationals (Lelamobile 2015). Our analysis in Engela District Hospital in Ohangwena region has revealed that there is need to improve basic TB control practices to ensure that all TB patients adhere to and complete TB treatment. The community-based DOTS is the main strategy of the TB programme, providing treatment for TB and

texila international journal of public health

The Importance of Geospatial Data on Multidrug-Resistant and Extensively Drug-resistant Tuberculosis Distribution in Engela District (Namibia): Retrospective cohort study