Biru Daniel, Woldesemayat Endrias Markos
UNICEF Ethiopia, Addis Ababa, Ethiopia.
Hawassa University, College of Medicine and Health Sciences, School of Public Health, Hawassa, Ethiopia.
Infect Drug Resist. 2020 Jun 16;13:1823-1829. doi: 10.2147/IDR.S256536. eCollection 2020.
In most developing countries, including in Ethiopia, the magnitude and risk factors of drug-resistant tuberculosis (DR-TB) are expected to be high. However, this is not well reported because of lack of laboratory facilities, poor surveillance system and limited reporting. The aim of this study was to determine the risk factors of DR-TB among TB patients in southern Ethiopia.
Facility-based case-control study was conducted from November 2016 to January 2017 in Sidama Zone and Gurage Zone of the southern Ethiopia region. DR-TB cases were confirmed by drug-susceptibility testing who were on treatment for DR-TB at Yirgalem and Butajira Hospitals. Controls were smear-positive pulmonary tuberculosis (TB) patients who were taking first-line anti-TB medications and sputum smear-negative at the 5 month of commencing TB treatment. Data were entered and cleaned using EPI-Info version 7 software and analyzed using SPSS version 22 statistical software.
A total of 84 cases and 243 controls participated in the study. About 59% (49 cases) and 55% (132 controls) were male. The median (interquartile range) age was 28 (21-37) years for cases and 27 (25-33) years for controls. Living in a one-roomed house (adjusted odds ratio [AOR]: 6.8, 95% CI: 1.8-25.8), history of contact with DR-TB cases (AOR: 6.8, 95% CI: 1.8-25.3), treatment failure TB cases (AOR: 4.2, 95% CI: 1.1-15.5) and relapsed TB cases (AOR: 4.8, 95% CI: 1.3-18.1) were independent factors associated with DR-TB.
Providing standardized first-line regimen for new case and retreatment TB cases and practicing basic TB-infection control measures could help to minimize the spread of DR-TB.
在包括埃塞俄比亚在内的大多数发展中国家，耐多药结核病（DR-TB）的规模和危险因素预计很高。然而，由于缺乏实验室设施、监测系统不完善以及报告有限，这方面的报道并不充分。本研究的目的是确定埃塞俄比亚南部结核病患者中耐多药结核病的危险因素。
2016年11月至2017年1月在埃塞俄比亚南部地区的锡达马州和古拉格州开展了一项基于医疗机构的病例对照研究。耐多药结核病病例通过药敏试验确诊，这些病例在伊尔加莱姆医院和布塔吉拉医院接受耐多药结核病治疗。对照为涂片阳性肺结核（TB）患者，他们正在服用一线抗结核药物，且在开始结核病治疗5个月时痰涂片阴性。数据使用EPI-Info 7软件录入和清理，并使用SPSS 22统计软件进行分析。
共有84例病例和243名对照参与了研究。约59%（49例）的病例和55%（132名对照）为男性。病例的年龄中位数（四分位间距）为28（21 - 37）岁，对照为27（25 - 33）岁。居住在单间房屋（调整优势比[AOR]：6.8，95%置信区间[CI]：1.8 - 25.8）、有耐多药结核病病例接触史（AOR：6.8，95% CI：1.8 - 25.3）、治疗失败的结核病病例（AOR：4.2，95% CI：1.1 - 15.5）和复发性结核病病例（AOR：4.8，95% CI：1.3 - 18.1）是与耐多药结核病相关的独立因素。
为新发病例和复治结核病病例提供标准化的一线治疗方案，并实施基本的结核病感染控制措施，有助于最大限度地减少耐多药结核病的传播。
