Ndiaye Mbouna, Yanogo Pauline Kiswendsida, Sawadogo Bernard, Diallo Fadima, Antara Simon, Meda Nicolas
West Africa Field Epidemiology Training Program (WAFETP).
Faculty of Medicine, University Ouaga 1, Professor Joseph Ki-zerbo, Burkina Faso.
J Public Health Afr. 2020 Mar 20;10(2):1099. doi: 10.4081/jphia.2019.1099. eCollection 2019 Dec 31.
According to the World Health Organization, multidrug-resistant tuberculosis (MDR-TB) represents a major obstacle towards successful TB treatment and control. In Dakar, MDR-TB management began in 2010 with the strengthening of diagnostic resources. The objective of this study was to identify the factors associated with multidrug-resistant tuberculosis in Dakar between 2010 and 2016. We conducted a case-control study from January 10 to February 28, 2017 in tuberculosis centers in Dakar. of 169 cases and 507 controls. We used logistic regression with Epi-info version 7.2.1. to estimate the odds ratios of association. Factors significantly associated with MDR-TB were: residing in a periurban area (ORa=1.8; 95% CI (1.5-4.9); p=0.024), presence of MDR-TB in the entourage of patient (ORa=7.0; 95% CI (6.1-9.5); p=0.002), previous treatment failure (ORa=29.5; 95% CI (27.3-30.1); p=0.000), treatment not directly observed by a health care provider (ORa=4.3; 95% CI (4.1-7,2); p=0.000) and irregularity of treatment (ORa=1.7; 95% CI (0.5-5.4); p=0.037). Focusing interventions on population at-risk will prevent MDR-TB.
根据世界卫生组织的说法,耐多药结核病(MDR-TB)是结核病成功治疗和控制的主要障碍。在达喀尔,耐多药结核病管理始于2010年,当时加强了诊断资源。本研究的目的是确定2010年至2016年期间达喀尔耐多药结核病的相关因素。我们于2017年1月10日至2月28日在达喀尔的结核病中心进行了一项病例对照研究,涉及169例病例和507例对照。我们使用Epi-info 7.2.1版本进行逻辑回归分析,以估计关联的比值比。与耐多药结核病显著相关的因素包括:居住在城市周边地区(比值比=1.8;95%置信区间(1.5-4.9);p=0.024)、患者周围有耐多药结核病患者(比值比=7.0;95%置信区间(6.1-9.5);p=0.002)、既往治疗失败(比值比=29.5;95%置信区间(27.3-30.1);p=0.000)、治疗未由医护人员直接观察(比值比=4.3;95%置信区间(4.1-7.2);p=0.000)以及治疗不规律(比值比=1.7;95%置信区间(0.5-5.4);p=0.037)。将干预措施重点放在高危人群上可预防耐多药结核病。