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尼日利亚拉各斯一家二级转诊医院疑似结核病患者中耐利福平结核病的患病率及相关因素

Prevalence of rifampicin resistant tuberculosis and associated factors among presumptive tuberculosis patients in a secondary referral hospital in Lagos Nigeria.

作者信息

Adejumo Olusola Adedeji, Olusola-Faleye Bolanle, Adepoju Victor, Bowale Abimbola, Adesola Sunday, Falana Ayodeji, Owuna Henry, Otemuyiwa Kehinde, Oladega Shafaatu, Adegboye Oluwatosin

机构信息

Mainland Hospital, Yaba Lagos Nigeria.

KNCV TB Foundation Nigeria/Challenge TB project, Lagos Nigeria.

出版信息

Afr Health Sci. 2018 Sep;18(3):472-478. doi: 10.4314/ahs.v18i3.2.

Abstract

BACKGROUND

Nigeria is one of the 30 high burden countries for drug resistant tuberculosis (DR-TB). This study assessed the prevalence and factors associated with rifampicin resistant tuberculosis (RR-TB) in a secondary referral hospital in Lagos State Nigeria.

METHODS

A retrospective review of presumptive TB register of patients screened for (MTB) and RR-TB using Xpert MTB/RIF assay at Mainland hospital between January 1 2012 and December 31 2016 was conducted.

RESULTS

A total of 2497 clients were screened for MTB and RR-TB during the study period. The majority (51.4%) were between 25 - 44 years. Male: Female ratio was 1:0.8. Of the 2497 clients screened, MTB was detected in 942 (37.7%) out of which 220 (23.4%) had RR-TB. Age (AOR 1.8, 95%CI 1.3- 2.6, p = 0.001), symptomatic contact with DR-TB patients (AOR 3.3, 95%CI 2.1-5.1, p <0.001) and type of TB (AOR 2.9, 95% CI 1.7 - 5.0, <0.001) were associated with RR-TB after adjusting for age, gender, HIV status and symptomatic contacts with DR-TB patients.

CONCLUSION

The prevalence of RR-TB in new and previously treated TB patients was high in this study. Urgent steps are needed to avert an impending RR-TB epidemic.

摘要

背景

尼日利亚是耐多药结核病(DR-TB)负担最重的30个国家之一。本研究评估了尼日利亚拉各斯州一家二级转诊医院中利福平耐药结核病(RR-TB)的患病率及相关因素。

方法

对2012年1月1日至2016年12月31日期间在大陆医院使用Xpert MTB/RIF检测法筛查结核分枝杆菌(MTB)和RR-TB的疑似结核病患者登记表进行回顾性分析。

结果

在研究期间,共有2497名患者接受了MTB和RR-TB筛查。大多数患者(51.4%)年龄在25 - 44岁之间。男女比例为1:0.8。在2497名接受筛查的患者中,检测出MTB的有942例(37.7%),其中220例(23.4%)患有RR-TB。在对年龄、性别、HIV感染状况以及与DR-TB患者的症状性接触进行调整后,年龄(调整后比值比[AOR]为1.8,95%置信区间[CI]为1.3 - 2.6,p = 0.001)、与DR-TB患者的症状性接触(AOR为3.3,95%CI为2.1 - 5.1,p <0.001)以及结核病类型(AOR为2.9,95%CI为1.7 - 5.0,p <0.001)与RR-TB相关。

结论

本研究中,新发病例和既往治疗过的结核病患者中RR-TB的患病率较高。需要采取紧急措施以避免即将到来的RR-TB流行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4b1/6307017/cd78afdb396a/AFHS1803-0472Fig1.jpg

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