Multi-drug-resistant tuberculosis in COVID-19 pandemic period, Dushanbe

Z. Tilloeva, A. Mirzoev
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Abstract

Aim. To evaluate the shifts in demographic, clinical, and epidemiological characteristics of patients with multidrugresistant tuberculosis (MDR TB) amidst the COVID-19 pandemic.Materials and Methods. A cross-sectional study was conducted on patients with MDR TB registered in Dushanbe, before (2017-2019) and during the COVID-19 pandemic (2020-2021).Results. The average age of patients prior to the COVID-19 pandemic was 36.5±16.9 years (1.7-79.4), whereas during the COVID-19 period, it was 34.4±17 years (2.9-80.2). The pandemic era witnessed a statistically significant rise in the proportion of workers among MDR TB patients compared to the unemployed (OR = 1.4; 95% CI 1.02-1.91; p = 0.05). Furthermore, an increase was observed in the proportion of patients with lung destruction in both newly diagnosed (OR 3.4; 95% CI 1.99–5.87; p<0.001) and previously treated patients (OR 4.2; 95% CI 1.38–12.99; p =0.002). There was also an increase in extrapulmonary tuberculosis registration (OR=1.7; 95% CI 1.34-2.22; p<0.001), indicating an unfavorable epidemiological situation in terms of MDR-TB. However, there were no statistically significant changes in the registration of concomitant diseases.Conclusion. We recommend the improvement of TB infection prevention and control measures at all levels, as well as the enhancement of early detection of TB and MDR TB patients by primary health care workers.
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COVID-19大流行期间的耐多药结核病,杜尚别
的目标。评估在COVID-19大流行期间耐多药结核病(MDR TB)患者的人口统计学、临床和流行病学特征的变化。材料与方法。对2019冠状病毒病大流行之前(2017-2019)和期间(2020-2021)在杜尚别登记的耐多药结核病患者进行了横断面研究。新冠肺炎流行前患者平均年龄为36.5±16.9岁(1.7 ~ 79.4岁),新冠肺炎流行期间患者平均年龄为34.4±17岁(2.9 ~ 80.2岁)。在大流行时期,与失业者相比,耐多药结核病患者中工人的比例在统计上显著上升(OR = 1.4;95% ci 1.02-1.91;P = 0.05)。此外,在新诊断的两组患者中,观察到肺破坏患者的比例增加(OR 3.4;95% ci 1.99-5.87;p<0.001)和以前治疗过的患者(OR 4.2;95% ci 1.38-12.99;p = 0.002)。肺外结核登记也有所增加(OR=1.7;95% ci 1.34-2.22;p<0.001),表明在耐多药结核病方面存在不利的流行病学形势。然而,伴随疾病的登记没有统计学上的显著变化。我们建议改进各级结核病感染预防和控制措施,并加强初级卫生保健工作者对结核病和耐多药结核病患者的早期发现。
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