莫桑比克南部的结核病耐药性：马尼卡区的一项人群水平调查结果

Tuberculosis drug resistance in Southern Mozambique: results of a population-level survey in the district of Manhiça.

作者信息

Valencia S, Respeito D, Blanco S, Ribeiro R M, López-Varela E, Sequera V G, Saavedra B, Mambuque E, Morillo M Gómez, Bulo H, Cobelens F, Macete E, Alonso P L, Caminero J A, García-Basteiro A L

机构信息

ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Rossello, Barcelona, Spain, Centro de Investigação em Saude de Manhiça, Maputo, Mozambique.

Centro de Investigação em Saude de Manhiça, Maputo, Mozambique.

出版信息

Int J Tuberc Lung Dis. 2017 Apr 1;21(4):446-451. doi: 10.5588/ijtld.16.0694.

DOI:10.5588/ijtld.16.0694

PMID:28284261

Abstract

SETTING

Mozambique, one of the world's high tuberculosis (TB) burden countries, has conducted only one national-level drug resistance survey, in 2007-2008.

OBJECTIVE

To determine the drug resistance patterns of laboratory-confirmed TB cases.

DESIGN

This was a population-level survey conducted over a 1-year period in the district of Manhiça. All laboratory-confirmed cases were evaluated for first-line anti-tuberculosis drug susceptibility testing using liquid culture.

RESULTS

Resistance to at least one first-line drug was observed in 44 of 276 isolates (15.9%). Prevalence of drug resistance to each of the five anti-tuberculosis drugs tested was 4.0% for streptomycin, 10.1% for isoniazid (INH), 6.2% for rifampicin, 3.6% for ethambutol and 1.1% for pyrazinamide. The overall prevalence of multidrug-resistant TB (MDR-TB) was 5.1%: 3.8% (95%CI 2.0-7.0) in new and 13.2% (95%CI 5.8-27.3) in retreatment cases. Respectively 4.6% and 2.6% of new and retreatment cases were INH-monoresistant. Previous history of anti-tuberculosis treatment was associated with having MDR-TB (OR 4.3, 95%CI 1.3-14.1).

CONCLUSION

The prevalence of drug resistance in the district of Manhiça is slightly higher than, but still compatible with, previous national estimates. INH monoresistance was high, posing the risk of hidden monotherapy in the continuation phase.

摘要

背景

莫桑比克是世界上结核病负担较重的国家之一，仅在2007 - 2008年进行过一次国家级耐药性调查。

目的

确定实验室确诊的结核病病例的耐药模式。

设计

这是一项在曼希卡区进行的为期1年的人群水平调查。所有实验室确诊病例均采用液体培养法进行一线抗结核药物敏感性检测。

结果

276株分离株中有44株（15.9%）对至少一种一线药物耐药。所检测的五种抗结核药物的耐药率分别为：链霉素4.0%，异烟肼（INH）10.1%，利福平6.2%，乙胺丁醇3.6%，吡嗪酰胺1.1%。耐多药结核病（MDR - TB）的总体患病率为5.1%：新发病例中为3.8%（95%CI 2.0 - 7.0），复治病例中为13.2%（95%CI 5.8 - 27.3）。新发病例和复治病例中分别有4.6%和2.6%为单一INH耐药。既往抗结核治疗史与MDR - TB相关（OR 4.3，95%CI 1.3 - 14.1）。