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埃塞俄比亚奥罗米亚地区贝尔地区公立卫生机构中儿童结核病的预测因素:病例对照研究。

Predictors of pediatric tuberculosis in public health facilities of Bale zone, Oromia region, Ethiopia: a case control study.

机构信息

College of Medicine and Health Sciences, Allied School of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.

, Addis Ababa, Ethiopia.

出版信息

BMC Infect Dis. 2018 Jun 4;18(1):252. doi: 10.1186/s12879-018-3163-0.

Abstract

BACKGROUND

Tuberculosis is among the top ten cause of death (9th) from a single infectious agent worldwide. It even ranks above HIV/AIDS. It is among the top 10 causes of death among children. Globally there are estimates of one million cases of TB in children, 76% occur in 22 high-burden countries among which Ethiopia ranked 8th. Despite this fact, children with TB are given low priority in most national health programs. Moreover reports on childhood TB and its predictors are very limited. Therefore this study aimed to assess predictors of pediatric Tuberculosis in Public Health Facilities.

METHODS

Unmatched case control study among a total samples of 432 (144 cases and 288 controls) were done from August to December 2016 in Bale zone, South East Ethiopia. Pediatric TB patients who attended health facilities for DOTS and those who attended health facilities providing DOTS service for any health problem except for TB were the study population for cases and controls, respectively. For each case two consecutive controls were sampled systematically. Data were collected using pretested and structured questionnaire through face to face interview with parents. Binary and multivariable logistic regression analyses were employed to identify predictors of Tuberculosis.

RESULT

Among cases there were equal number of male and female 71(50%). However among control 136 (47.9%) were male and the rest were female. The mean (standard deviation) of age among cases was 8.4 (±4.3) and controls were 7.3 (±4.1). The odds of TB were 2 times (AOR, 95% CI = 1.94(1.02-3.77)) more likely among 11-15 age group children when compared with children of age group ≤5. HIV status of the child, children who were fed raw milk and absence of BCG vaccination were the other predictors of pediatric TB with AOR 13.6(3.45-53.69), 4.23(2.26-7.88), and 5.46(1.82-16.32) respectively.

CONCLUSION

Children who were not BCG Vaccinated were at risk of developing TB. Furthermore, HIV status, age of the child and family practice of feeding children raw milk are the independent predicators of pediatric TB in the study area.

摘要

背景

结核病是全球十大死因(第 9 位)之一,也是由单一传染病原体引起的。它甚至高于艾滋病毒/艾滋病。它也是儿童十大死因之一。全球估计有 100 万例儿童结核病,其中 76%发生在 22 个高负担国家,其中埃塞俄比亚排名第 8 位。尽管如此,在大多数国家卫生计划中,儿童结核病的优先级仍然很低。此外,关于儿童结核病及其预测因素的报告非常有限。因此,本研究旨在评估公立卫生机构中儿科结核病的预测因素。

方法

2016 年 8 月至 12 月,在埃塞俄比亚东南部的巴莱地区,对总共 432 名(144 例病例和 288 名对照)进行了非匹配病例对照研究。病例组为在卫生机构接受直接观察治疗 (DOTS) 的儿科结核病患者,对照组为在卫生机构接受 DOTS 服务的患者,用于除结核病以外的任何健康问题。对于每个病例,系统地抽取了两个连续的对照。通过面对面访谈,使用预先测试和结构化问卷收集数据,由父母提供。采用二项和多变量逻辑回归分析来确定结核病的预测因素。

结果

在病例中,男性和女性的数量相等,各有 71 人(50%)。然而,在对照组中,有 136 名(47.9%)是男性,其余是女性。病例组的平均(标准差)年龄为 8.4(±4.3)岁,对照组为 7.3(±4.1)岁。与年龄组≤5 岁的儿童相比,11-15 岁年龄组的儿童患结核病的几率高 2 倍(比值比,95%可信区间=1.94(1.02-3.77))。儿童的 HIV 状况、食用生牛奶和未接种卡介苗是儿科结核病的其他预测因素,比值比分别为 13.6(3.45-53.69)、4.23(2.26-7.88)和 5.46(1.82-16.32)。

结论

未接种卡介苗的儿童患结核病的风险更高。此外,HIV 状况、儿童年龄和家庭食用生牛奶的习惯是该研究地区儿科结核病的独立预测因素。

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