Prevalence of Rifampicin Resistance and Associated Risk Factors among Suspected Multidrug Resistant Tuberculosis Cases in TB Centers Mogadishu-Somalia: Descriptive Study

A. Guled, Ayub Hassan Elmi, Bashir Mohamud Abdi, Abdihamid Mohamed Ali Rage, F. Ali, Abdullahi Hassan Abdinur, Abdullah Ali, A. A. Ahmed, Khadra Abdullahi Ibrahim, S. Mohamed, F. Mire, Omar Abdi Adem, Ali Osman
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引用次数: 5

Abstract

Introduction and Background: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a significant global health concern. Patients who had failed previous TB treatment, relapsed after treatment, contacted known MDRTB patients or defaulted during previous treatment, and HIV patients are considered to be suspected and at high risk for developing drug resistant TB specially MDR-TB. However, there is little data available on the prevalence and trends of MDR tuberculosis in national level but luck of it in Mogadishu is our main concern. Methodology: This was a crosssectional, descriptive study involving all suspected MDR TB patients attended at the Mogadishu three Tb centers. Results: A total of 138 cases of suspected MDRTB patients were included in the study. Of these, 70 patients (51%) had rifampicin resistant-TB. Of the 138 study participants, 94 (68.62%) were between 21 - 40 years old that indicates the dominance of productive age group (21 - 40 years). Previous Tuberculosis treatment has been noted to be a major risk factor for development of multidrug resistance tuberculosis. MDR-TB prevalence is significantly higher in male than female patients. Conclusion and Interpretation: The prevalence of Rifampicin resistance among these high risk groups was significant. The high association of previous TB treatment to MDR-TB might be explained due to inappropriate anti-tubercular regimens, sub-optimal drugs, inadequate or irregular drug supply, unsatisfactory patient or clinician compliance, lack of supervision of treatment and absence of infection control measures in healthcare facilities. As the prevalence of MDRTB is high and yet the cases remain un-isolated in the community we recommend the MOH/NTP and funding agencies to facilitate establishment of MDRTB management centers earlier in Mogadishu in order to treat the MDRTB case otherwise it might Amplify of the incidence of this Emerging Disease.
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摩加迪沙-索马里结核病中心疑似耐多药结核病病例中利福平耐药患病率及相关危险因素:描述性研究
介绍和背景:耐多药结核病(MDR-TB)已成为一个重大的全球卫生问题。既往结核病治疗失败、治疗后复发、接触已知耐多药结核病患者或在既往治疗期间未进行治疗的患者,以及艾滋病毒患者被认为有发生耐药结核病特别是耐多药结核病的嫌疑和高风险。然而,关于耐多药结核病在国家一级的流行率和趋势的数据很少,但摩加迪沙的运气是我们主要关注的问题。方法:这是一项横断面描述性研究,涉及在摩加迪沙三个结核病中心就诊的所有疑似耐多药结核病患者。结果:本研究共纳入138例疑似耐多药结核病患者。其中,70名患者(51%)患有利福平耐药结核。在138名研究参与者中,94名(68.62%)在21 - 40岁之间,这表明生产年龄组(21 - 40岁)占主导地位。以往的结核病治疗已被认为是发展为多药耐药结核病的主要危险因素。男性耐多药结核病患病率明显高于女性患者。结论与解释:这些高危人群中利福平耐药的发生率显著。以往结核病治疗与耐多药结核病的高度关联可能是由于不适当的抗结核方案、次优药物、药物供应不足或不规律、患者或临床医生不满意的依从性、缺乏对治疗的监督以及卫生保健机构缺乏感染控制措施。由于耐多药结核病的流行率很高,但这些病例在社区中仍未被隔离,我们建议卫生部/国家结核控制规划和供资机构促进在摩加迪沙尽早建立耐多药结核病管理中心,以便治疗耐多药结核病病例,否则可能会扩大这一新兴疾病的发病率。
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