In this study, about 176 study participants enrolled time to unfavorable TB treatment outcomes during the study period. The median age was 97 months [IQR: 65–144], and 63% were males. The median baseline BMI was 14.12 [IQR: 12.21–16.56] Kg/m2. During the follow-up period, the overall incidence density rate of unfavorable treatment outcomes was 14.18 per 10,000 populations per day at 95% CI (12.23-16.43). Being male [AHR = 1.63; 95% CI: 1.11, 2.40], HIV positive [AHR = 7.08; 95% CI: 3.72, 13.48], and had a history of comorbidities [AHR = 3.62; 95% CI: 1.28, 10.25], were statistically significant predictors of unfavorable treatment outcome.