Abdella Kedir, Abdissa Ketema, Kebede Wakjira, Abebe Gemeda
Department of Medical Laboratory Science and Pathology, College of Health sciences, Jimma University, Jimma, Ethiopia.
Mycobacteriology Research Centre, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia.
BMC Public Health. 2015 Jul 2;15:599. doi: 10.1186/s12889-015-1955-3.
Information on the pattern of drug resistant tuberculosis (TB) among re-treatment cases is crucial to develop appropriate control strategies. Therefore, we conducted this study to assess the drug resistance pattern of M. tuberculosis complex (MTBC) isolates and associated factors among re-treatment cases in Jimma area, Southwest Ethiopia.
Health facility-based cross-sectional study was conducted between March 2012 and April 2013 in Jimma area, Southwest Ethiopia. We included 79 re-treatment cases selected conveniently. Socio demographic and clinical data were collected using structured questionnaire. Sputum sample processing, mycobacterial culture, isolation and drug susceptibility testing (DST) were done at Mycobacteriology Research Centre (MRC) of Jimma University. All data were registered and entered in to SPSS version 20. Crude odds ratio (COR) and adjusted odds ratios (AOR) were calculated. P-values less than 0.05 were considered statistically significant.
Seventy-nine re-treatment cases included in the study; 48 (60.8%) were males. Forty-seven (59.5%) study participants were from rural area with the mean age of 31.67 ± 10.02 SD. DST results were available for 70 MTBC isolates. Majority (58.6% (41/70)) isolates were resistant to at least one of the four first line drugs. The prevalence of multidrug-resistant TB (MDR-TB) was 31.4% (22/70). Place of residence (AOR = 3.44 (95 % CI: 1.12, 10.60), duration of illness (AOR = 3.00 (95 % CI: 1.17, 10.69) and frequency of prior TB therapy (AOR = 2.99, (95 % CI: 1.01, 8.86) were significant factors for any drug resistance. Moreover, history of treatment failure was found to be associated with MDR-TB (AOR = 3.43 (95 % CI: 1.14, 10.28).
The overall prevalence of MDR-TB among re-treatment cases around Jimma was high. The rate of MDR-TB was higher in patients with the history of anti-TB treatment failure. Timely identification and referral of patients with the history of treatment failure for culture and DST need to be strengthened.
复治病例中耐多药结核病(TB)模式的信息对于制定适当的控制策略至关重要。因此,我们开展了本研究,以评估埃塞俄比亚西南部吉马地区复治病例中结核分枝杆菌复合群(MTBC)分离株的耐药模式及相关因素。
2012年3月至2013年4月在埃塞俄比亚西南部吉马地区开展了一项基于医疗机构的横断面研究。我们方便选取了79例复治病例。使用结构化问卷收集社会人口统计学和临床数据。痰标本处理、分枝杆菌培养、分离及药敏试验(DST)在吉马大学分枝杆菌研究中心(MRC)进行。所有数据进行登记并录入SPSS 20版。计算粗比值比(COR)和调整比值比(AOR)。P值小于0.05被认为具有统计学意义。
本研究纳入79例复治病例;48例(60.8%)为男性。47例(59.5%)研究参与者来自农村地区,平均年龄为31.67±10.02标准差。70株MTBC分离株有药敏试验结果。大多数(58.6%(41/70))分离株对四种一线药物中的至少一种耐药。耐多药结核病(MDR-TB)患病率为31.4%(22/70)。居住地(AOR = 3.44(95%CI:1.12,10.60))、病程(AOR = 3.00(95%CI:1.17,10.69))和既往抗结核治疗频率(AOR = 2.99,(95%CI:1.01,8.86))是任何耐药的显著因素。此外,治疗失败史与MDR-TB相关(AOR = 3.43(95%CI:1.14,10.28))。
吉马周边复治病例中MDR-TB总体患病率较高。有抗结核治疗失败史的患者中MDR-TB发生率更高。需要加强对有治疗失败史患者的及时识别并转诊进行培养和DST。