埃塞俄比亚北部提格雷地区推定耐多药结核病患者中耐多药结核病的患病率和相关因素

K. Mehari, Tsehaye Asmelash, Haftamu Hailekiros, Tewolde Wubayehu, H. Godefay, Tadele Araya, M. Saravanan
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引用次数: 24

摘要

结核病(TB)是主要的公共卫生问题之一。有令人震惊的报告称,包括埃塞俄比亚在内的全球各地耐多药结核病(MTR-TB)正在增加。本研究旨在确定埃塞俄比亚提格雷地区州推定耐多药结核病病例中耐多药结核病的患病率和相关因素。方法2015 - 2016年在提格雷地区州进行横断面研究。收集200份痰样本,运输后用2% n -乙酰- l-半胱氨酸-氢氧化钠处理,并在LJ培养基中培养。锌染色后进行显微检查。采用分子线探针法进行药敏试验。描述性统计和二元及多变量logistic回归分析。当P值<0.05时,认为有统计学意义。结果耐多药结核病患病率为18.5%。约四分之一(26.5%)的研究参与者痰涂片抗酸杆菌(AFB)阳性。在37%的样本中结核培养呈阳性,利福平单药耐药病例占推定耐多药结核病病例的3.5%。3例(1.5%)为耐多药结核病新发病例,其余病例以前曾接受过结核病治疗。大多数耐多药结核病例(63.5%)年龄在15至44岁之间。年龄与耐多药结核病相关,粗比值比为1.06 (CI: 1.02-1.10),校正比值比为1.06 (CI: 1.00-1.11)。结论该地区耐多药结核病患病率较高。应采取预防措施,防止耐多药结核病在社区传播。
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Prevalence and Factors Associated with Multidrug-Resistant Tuberculosis (MDR-TB) among Presumptive MDR-TB Patients in Tigray Region, Northern Ethiopia
Background Tuberculosis (TB) is one of the major public health problems. There are alarming reports of increasing multidrug-resistant tuberculosis (MTR-TB) from various parts of the globe, including Ethiopia. This study was designed to determine the prevalence and factors associated with MDR-TB among presumptive MDR-TB cases in Tigray Regional State, Ethiopia. Methods A cross-sectional study was conducted in Tigray Regional State from 2015 to 2016. Two hundred sputum samples were collected, transported, processed using 2% N-acetyl-L-cysteine-sodium hydroxide, and cultured in LJ medium. Besides, the microscopic examination was performed after ZN staining. Moreover, drug susceptibility test was done using molecular line probe assay. Descriptive statistics and binary and multivariable logistic regression were done. A statistical test was regarded as significant when the P value was <0.05. Results The prevalence of MDR-TB was found to be 18.5%. About one-fourth (26.5%) of the study participants had sputum smear positive for acid-fast bacilli (AFB). TB culture was positive in 37% of the samples, and rifampicin mono-resistant cases accounted for 3.5% of the presumptive MDR-TB cases. Three (1.5%) were new MDR-TB cases, while the rest had been treated previously for TB. Most (63.5%) of the MDR-TB cases were from 15 to 44 years of age. Age was associated with MDR-TB with a crude odds ratio of 1.06 (CI: 1.02–1.10) and adjusted odds ratio of 1.06 (CI: 1.00–1.11). Conclusions The prevalence of MDR-TB was found to be high. Preventive measures should be taken to prevent the transmission of MDR-TB in the community.
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