Sinha Pallavi, Srivastava G N, Gupta Anamika, Anupurba Shampa
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Department of Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
J Glob Infect Dis. 2017 Oct-Dec;9(4):139-145. doi: 10.4103/jgid.jgid_167_16.
India is one of the high tuberculosis (TB) burden countries in the world. Improper implementation in the guidelines for the management of TB and high rate of defaults on the part of the patients are most important risk factors for the development of multi-drug resistant TB.
This study examines the drug resistance profile and the effect of demographic, clinical and behavioral risk factors on the prevalence of TB and multidrug resistance (MDR) in north India.
This was a prospective, observational study carried out from May 2012 to February 2014 in tertiary care hospital of Varanasi.
The study was performed on 721 pulmonary and extrapulmonary specimens of suspected TB patients based on history, was subjected for the Ziehl-Neelsen staining and culture on Lowenstein-Jensen (LJ) media.
The features of groups were compared by Chi-square (χ) and odds ratio.
Out of 721 clinically suspected pulmonary and extrapulmonary TB patients, 222 (30.8%) patients were smear positive for acid-fast bacilli and 244 (38.3%) were positive for species cultured on LJ medium. The prevalence of resistance to at least one anti-TB drug was 71.1% and MDR was 53.5%. Age, gender, HIV status, nature of TB, smoking, and alcohol consumption risk factors were significantly associated with TB prevalence; while prior history of TB infection, pervious household exposure, smoking, and alcohol consumption were significantly associated with MDR.
This study showed a high prevalence of drug resistance TB in this region. It also provides evidence in our circumstance, of the role of prior history of TB infection, alcohol and smoking in increasing the risk of developing TB and MDR-TB. Therefore, it is necessary for the public health community to incorporate and strengthen alcohol and smoking nonparticipation interference in TB control program.
印度是世界上结核病负担较重的国家之一。结核病管理指南实施不当以及患者的高违约率是耐多药结核病发生的最重要风险因素。
本研究调查印度北部结核病的耐药情况以及人口统计学、临床和行为风险因素对结核病患病率和耐多药情况的影响。
这是一项于2012年5月至2014年2月在瓦拉纳西的三级护理医院进行的前瞻性观察研究。
基于病史，对721例疑似结核病患者的肺和肺外标本进行萋-尼氏染色，并在罗-琴（LJ）培养基上进行培养。
采用卡方（χ）检验和比值比比较各组特征。
在721例临床疑似肺和肺外结核病患者中，222例（30.8%）痰涂片抗酸杆菌阳性，244例（38.3%）在LJ培养基上培养出结核杆菌。至少对一种抗结核药物耐药的患病率为71.1%，耐多药率为53.5%。年龄、性别、艾滋病毒感染状况、结核病类型、吸烟和饮酒等风险因素与结核病患病率显著相关；而既往结核感染史、既往家庭接触史、吸烟和饮酒与耐多药情况显著相关。
本研究显示该地区耐多药结核病患病率较高。同时也证明，在我们的环境中，既往结核感染史、饮酒和吸烟在增加结核病和耐多药结核病发病风险方面的作用。因此，公共卫生界有必要将并加强控烟和限酒干预措施纳入结核病控制项目。
