Waziri Ndadilnasiya Endie, Cadmus Simeon, Nguku Patrick, Fawole Olufunmilayo, Owolodun Olajide Adewale, Waziri Hyelshilni, Ibrahim Luka, Biya Oladayo, Gidado Saheed, Badung Samuel, Kumbish Peterside, Nsubuga Peter
Nigeria Field Epidemiology and Laboratory Training Program, Nigeria.
Department of Veterinary Public Health, University of Ibadan, Nigeria.
Pan Afr Med J. 2014 Jul 21;18 Suppl 1(Suppl 1):5. doi: 10.11694/pamj.supp.2014.18.1.4189. eCollection 2014.
Tuberculosis remains a global public health problem. In 2011, tuberculosis incidence was 133 per 100,000 in Nigeria. In Nigeria, little is known about the factors associated with tuberculosis, especially in the northern part and only few studies have characterized the Mycobacterium species that cause tuberculosis infection in humans. This study determined factors associated with tuberculosis and identified Mycobacterium species causing human tuberculosis in North-West, Nigeria.
We conducted a hospital based case control study between April and July 2010 in Zaria. Cases were newly diagnosed sputum smear-positive tuberculosis patients >15 years while controls were patients >15 years attending the hospital for other reasons but were negative for tuber-culosis. We used a structured questionnaire to obtain information on demographics, knowledge of transmission of tuberculosis, and exposure to some factors. We preformed descriptive, bivariate and backward elimination logistic regression. Sputa from cases were analyzed by multiplex polymerase chain reaction (PCR) based on genomic regions of difference.
The mean ages of the cases and controls were 36, standard deviation (SD) 9.0 and 36, SD 9.7 respectively. Only 10 (9.8%) and nine (8.8%) of cases and controls respectively had a good knowledge of the transmission of tuberculosis. Contact with a tuberculosis patient (adjusted odds ratio (AOR) 12.3, 95% confidence interval (CI) 5.2-28.8), consumption of unpasteurized milk (AOR 6.4, CI 2.4-17.2), keeping pets (AOR 5.6, CI 2.3-13.7), associating closely with cattle (AOR 5.6, CI 1.3-6.8), and overcrowding (AOR 4.8, CI 1.8-13.1) were significantly associated with tuberculosis. Of the 102 sputa analyzed, 91 (89%) were M. tuberculosis, 8 (7.8%) were M africanum.
We identified possible opportunities for intervention to limit the spread of tuberculosis. We recommend that the Nigeria tuberculosis control program consider some of these factors as a way to mitigate the spread of tuberculosis in Nigeria.
结核病仍然是一个全球公共卫生问题。2011年,尼日利亚的结核病发病率为每10万人中有133例。在尼日利亚,人们对与结核病相关的因素知之甚少,尤其是在北部地区,而且仅有少数研究对导致人类结核病感染的分枝杆菌种类进行了特征描述。本研究确定了与结核病相关的因素,并鉴定了尼日利亚西北部导致人类结核病的分枝杆菌种类。
2010年4月至7月,我们在扎里亚开展了一项基于医院的病例对照研究。病例为新诊断的痰涂片阳性结核病患者,年龄大于15岁,而对照为因其他原因到医院就诊但结核病检测呈阴性的年龄大于15岁的患者。我们使用一份结构化问卷来获取有关人口统计学、结核病传播知识以及接触某些因素的信息。我们进行了描述性、双变量和向后消除逻辑回归分析。基于差异基因组区域通过多重聚合酶链反应(PCR)对病例的痰液进行分析。
病例组和对照组的平均年龄分别为36岁,标准差(SD)为9.0和36岁,SD为9.7。病例组和对照组中分别只有10例(9.8%)和9例(8.8%)对结核病传播有充分了解。与结核病患者接触(调整比值比(AOR)12.3,95%置信区间(CI)5.2 - 28.8)、饮用生牛奶(AOR 6.4,CI 2.4 - 17.2)、饲养宠物(AOR 5.6,CI 2.3 - 13.7)、与牛密切接触(AOR 5.6,CI 1.3 - 6.8)以及过度拥挤(AOR 4.8,CI 1.8 - 13.1)与结核病显著相关。在分析的102份痰液中,91份(89%)为结核分枝杆菌,8份(7.8%)为非洲分枝杆菌。
我们确定了限制结核病传播的可能干预机会。我们建议尼日利亚结核病控制项目将其中一些因素考虑在内,以此作为减轻尼日利亚结核病传播的一种方式。