Worku Yoseph, Getinet Tewodros, Mohammed Shikur, Yang Zhenhua
Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Int J Mycobacteriol. 2018 Apr-Jun;7(2):167-172. doi: 10.4103/ijmy.ijmy_48_18.
Tuberculosis (TB) programs should design intervention strategies based on the sound knowledge of the existing local epidemiology and sociodemographic characteristics of drug-resistant-TB (DR-TB) cases. The aim of the study was to characterize the pulmonary multidrug-resistant (MDR) and rifampicin-resistant (RR) TB cases enrolled in a referral hospital at Addis Ababa, Ethiopia, called All Africa Leprosy, Tuberculosis, Rehabilitation and Training (ALERT) Hospital.
We conducted a descriptive study based on retrospective review of medical records of 340 pulmonary MDR/RR-TB cases enrolled in ALERT Hospital from November 2011 to December 2016. To characterize the cases, we described the distribution of demographic and clinical characteristics. To compare the distribution of demographic and clinical characteristics between male and female cases, we used Pearson's Chi-squared test.
Males accounted for 52.9% of the 340 cases. Nine out of ten cases were in the age group of 15-44 years. Sputum acid-fast bacilli smear-positive and human immunodeficiency virus-coinfected cases constituted 63.7% and 18.1% of cases, respectively. The proportion of new cases increased through the years from nil in 2011 to 21.4% in 2016. Adult males above 24 years constituted more than three quarters (77.2%) of the total male cases, while adult females in this age group constituted 56.9%. The age distribution between male and female cases showed significant differences (P < 0.001).
There is age disparity between male and female cases with high impact of MDR/RR-TB on productive adult male population. The transmission potential for DR-TB is also high in the community.
结核病防治项目应基于对现有当地耐药结核病(DR-TB)病例的流行病学和社会人口学特征的充分了解来设计干预策略。本研究的目的是对埃塞俄比亚亚的斯亚贝巴一家转诊医院——全非洲麻风病、结核病、康复与培训(ALERT)医院收治的耐多药(MDR)和利福平耐药(RR)肺结核病例进行特征描述。
我们进行了一项描述性研究,回顾性分析了2011年11月至2016年12月在ALERT医院登记的340例肺结核MDR/RR-TB病例的病历。为描述病例特征,我们描述了人口统计学和临床特征的分布情况。为比较男性和女性病例的人口统计学和临床特征分布,我们使用了Pearson卡方检验。
340例病例中男性占52.9%。十分之九的病例年龄在15 - 44岁之间。痰涂片抗酸杆菌阳性病例和合并感染人类免疫缺陷病毒的病例分别占病例总数的63.7%和18.1%。新发病例的比例逐年增加,从2011年的零增至2016年的21.4%。24岁以上成年男性占男性病例总数的四分之三以上(77.2%),而该年龄组成年女性占56.9%。男性和女性病例的年龄分布存在显著差异(P < 0.001)。
耐多药/利福平耐药肺结核病例在男性和女性之间存在年龄差异,对有生产能力的成年男性人群影响较大。社区中耐多药结核病的传播潜力也很高。