National Tuberculosis Reference Laboratory, Ministry of Health, Gaborone, Botswana.
Department of Epidemiology and Biostatistics, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
BMC Infect Dis. 2019 Sep 6;19(1):779. doi: 10.1186/s12879-019-4375-7.
To investigate the prevalence and factors associated with the prevalence of multidrug/rifampicin-resistant tuberculosis among suspected drug resistant tuberculosis patients in Botswana.
A retrospective review of medical records of suspected drug resistant tuberculosis patients receiving care at public health facilities in Botswana was conducted from January, 2013 and December, 2014. Patient characteristics and drug susceptibility data were abstracted from 2568 medical records on to a pre-tested checklist form. The prevalence of multidrug/rifampicin resistance was computed. Bivariate and multivariate logistic regression was carried out to determine the factors associated with the prevalence of multidrug/rifampicin in the study population.
Overall, multidrug/ rifampicin - resistance among suspected drug resistant tuberculosis patients in Botswana were found in 139 (5.4%) cases with 1.3% among new cases and 7.7% among previously treated tuberculosis patients. Being a previously treated tuberculosis patient and having a positive smear were found to be factors associated with the prevalence of multidrug/rifampicin-resistant tuberculosis (p < 0.05). However, age, sex, living in urban area and HIV status were not associated with this disease (p > 0.05).
This study highlights a low burden of multidrug/rifampicin resistant tuberculosis among suspected drug resistant tuberculosis patients receiving care at public health facilities in Botswana. Strategies in controlling MDR/RR-TB should emphasize on effective implementation of Directly Observation Treatment - short course strategy, continuous surveillance of drug resistance cases, prevention of the development of new cases of MDR/RR-TB and to treat existing patients. Further interventions should focus on strengthening TB infection control activities.
调查博茨瓦纳疑似耐药结核病患者中耐多药/利福平耐药结核病的流行情况及其相关因素。
对 2013 年 1 月至 2014 年 12 月期间在博茨瓦纳公立卫生机构接受治疗的疑似耐药结核病患者的病历进行回顾性审查。从 2568 份病历中提取患者特征和药物敏感性数据，并将其记录到一份预先测试的检查表中。计算耐多药/利福平耐药的流行率。采用二变量和多变量逻辑回归分析确定研究人群中与耐多药/利福平耐药流行相关的因素。
总体而言，博茨瓦纳疑似耐药结核病患者中耐多药/利福平耐药的比例为 139 例（5.4%），其中新发病例为 1.3%，既往治疗过的结核病患者为 7.7%。既往治疗过的结核病患者和痰检阳性被认为是耐多药/利福平耐药结核病流行的相关因素（p<0.05）。然而，年龄、性别、居住在城市地区和 HIV 状况与该疾病无关（p>0.05）。
本研究表明，在博茨瓦纳公立卫生机构接受治疗的疑似耐药结核病患者中，耐多药/利福平耐药结核病的负担较低。控制耐多药/利福平耐药结核病的策略应重点有效实施直接观察治疗-短程策略，持续监测耐药病例，预防新的耐多药/利福平耐药结核病的发生，并治疗现有患者。进一步的干预措施应侧重于加强结核病感染控制活动。
