Workicho Abdulhalik, Kassahun Wondwosen, Alemseged Fessahaye
Department of Epidemiology, College of Health Sciences, Jimma University, Jimma, Ethiopia.
Infect Drug Resist. 2017 Mar 13;10:91-96. doi: 10.2147/IDR.S126274. eCollection 2017.
Multidrug-resistant tuberculosis (MDR-TB) did not receive major attention until recently in sub-Saharan Africa where the tuberculosis incidence and risk factors are highest. Factors leading to development of drug resistance need to be understood to develop appropriate control strategies for national programs. The objective of this study was to identify the risk factors for MDR-TB among tuberculosis patients.
A case-control study was conducted to assess sociodemographic, behavioral and clinical risk factors using a structured questionnaire and clinical record reviewing. The data were entered and analyzed using SPSS windows version 16. Descriptive analysis was done to generate summary values for the variables and those significant variables in the bivariate analysis at -value less than 0.25 were entered to multivariable logistic regression to identify independent determinants. Statistical significance was declared at -value less than or equal to 0.05.
A total of 90 cases and 90 controls were included in the study. Age of respondents (adjusted odds ratio [AOR] =7; 95% confidence interval [CI]: 2.6-24.5), living in a household with only one room (AOR=5; 95%CI: 1.68-15.38), history of previous treatment (AOR=21; 95% CI: 17.8-28) and being HIV infected (AOR=3.1; 95%CI: 1.02-9.4) were found to be independent predictors of MDR-TB.
In light of these findings, the strategies in controlling MDR-TB should emphasize on patients with HIV coinfection, young patients, those who have a history of previous treatment, and those living in crowded places.
耐多药结核病(MDR-TB)直到最近才在撒哈拉以南非洲受到主要关注,而该地区结核病发病率和风险因素最高。为国家项目制定适当的控制策略,需要了解导致耐药性产生的因素。本研究的目的是确定结核病患者中耐多药结核病的风险因素。
进行了一项病例对照研究,使用结构化问卷和临床记录回顾来评估社会人口统计学、行为和临床风险因素。数据使用SPSS 16.0 for Windows版本录入和分析。进行描述性分析以生成变量的汇总值,双变量分析中P值小于0.25的显著变量被纳入多变量逻辑回归以确定独立决定因素。P值小于或等于0.05时具有统计学意义。
该研究共纳入90例病例和90例对照。受访者年龄(调整比值比[AOR]=7;95%置信区间[CI]:2.6-24.5)、居住在单间家庭(AOR=5;95%CI:1.68-15.38)、既往治疗史(AOR=21;95%CI:17.8-28)和感染艾滋病毒(AOR=3.1;95%CI:1.02-9.4)被发现是耐多药结核病的独立预测因素。
鉴于这些发现,控制耐多药结核病的策略应强调合并感染艾滋病毒的患者、年轻患者、有既往治疗史的患者以及居住在拥挤场所的患者。