2017 年，埃塞俄比亚西北省东戈贾姆和西戈贾姆地区抗逆转录病毒治疗中心就诊成年人结核病感染的预测因素。
Predictors of tuberculosis infection among adults visiting anti-retroviral treatment center at east and west Gojjam, northwest, Ethiopia, 2017.
机构信息
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Markos University, 269, Debre Markos, Ethiopia.
Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, 269, Debre Markos, Ethiopia.
出版信息
BMC Infect Dis. 2020 Aug 12;20(1):593. doi: 10.1186/s12879-020-05290-2.
BACKGROUND
Tuberculosis is a serious health risk, for people living with human immune deficiency virus worldwide, and the burden of TB/HIV infection is still high in Ethiopia in particular. Therefore, the aim of this study was to determine the predictors of tuberculosis infection among adults visiting anti-retroviral treatment center in East and West Gojjam, northwest, Ethiopia.
METHODS
Institution based unmatched case-control study was employed to determine the predictors of tuberculosis infection among adults visiting anti-retroviral treatment center in east and west Gojjam, Northwest, Ethiopia from March 7-April 15, 2017. Just about 552 participants were participated in the study (139 Cases and 413 controls). Cases were confirmed with active TB and infected with HIV, and controls were HIV positive adults with non-TB. All cases in each health facility who confirmed by acid-fast bacilli, culture and gene expert were considered as TB positive. However, controls were selected by using simple random sampling technique through the above diagnostic criteria and the data were collected with Face to face interview as well as patient medical record were utilized, and the quality of the data were assured, checked, coded, cleaned and entered in EPI-Data version 3.1 and exported to SPSS version 20 for the analysis.
RESULT
Of the total sample (556), just about 552(99.2%) were participated in the study. 47.5% were females and 58.9% were rural dweller. Behavioral and modifiable biological risk factors: alcohol users (AOR = 2.33; 95%CI:1.34,4.07), BMI < 18.5 kg/ (AOR = 3.03;95%CI:1.79,5.14), CD4 count ≤200 cells/μl (AOR = 2.34;95%CI:1.89,2.79) and between 201 and 499 cells/μl (AOR = 2.63; 95%CI: 1.01,6.84), bedridden and ambulatory (AOR = 3.3;95%CI:1.70,6.29 and AOR = 8.2;95%CI:4.34,15.64), respectively. TB history in the family (AOR = 3.00; 95%CI: 1.57, 5.74) were predictors for TB infection. Taking CPT (AOR = 0.36; 95%CI: 0.21, 0.62) and having early WHO clinical stage I or II (AOR = 0.34; 95%CI: 0.20, 0.56) had protective effect against TB infection.
CONCLUSION
From this study, it has been concluded that alcohol users, BMI < 18.5 kg/m, CD4 count < 499 cells/μl, bedridden and ambulatory and TB history were predictors for TB-HIV co-infected adults. Strengthen screening more frequently, CPT Prophlaxysis and treated promptly important to reduce TB co-morbidity.
背景
结核病是全世界人类免疫缺陷病毒感染者的严重健康威胁，特别是在埃塞俄比亚，结核和艾滋病毒双重感染的负担仍然很高。因此，本研究的目的是确定在东沃洛和西沃洛，西北，埃塞俄比亚的抗逆转录病毒治疗中心就诊的成年人中结核病感染的预测因素。
方法
采用基于机构的病例对照研究，以确定 2017 年 3 月 7 日至 4 月 15 日在东沃洛和西沃洛，西北，埃塞俄比亚的抗逆转录病毒治疗中心就诊的成年人中结核病感染的预测因素。大约有 552 名参与者参加了这项研究（139 例病例和 413 例对照）。病例是通过抗酸杆菌、培养和基因专家确诊的活动性结核病和感染艾滋病毒的患者，而对照是无结核病的艾滋病毒阳性成年人。每个医疗机构的所有病例都被认为是通过上述诊断标准确诊的结核病阳性病例。然而，对照是通过简单随机抽样技术选择的，并且通过上述诊断标准收集数据，并通过面对面访谈以及利用患者的医疗记录，确保了数据的质量，对数据进行了检查、编码、清理，并输入 EPI-Data 版本 3.1，然后导出到 SPSS 版本 20 进行分析。
结果
在总样本（556）中，大约有 552 人（99.2%）参与了研究。其中 47.5%为女性，58.9%为农村居民。行为和可改变的生物学危险因素：饮酒者（AOR=2.33；95%CI：1.34，4.07）、BMI<18.5kg/（AOR=3.03；95%CI：1.79，5.14）、CD4 计数≤200 个细胞/μl（AOR=2.34；95%CI：1.89，2.79）和 201-499 个细胞/μl（AOR=2.63；95%CI：1.01，6.84）、卧床不起和活动能力（AOR=3.3；95%CI：1.70，6.29 和 AOR=8.2；95%CI：4.34，15.64），TB 家族史（AOR=3.00；95%CI：1.57，5.74）是结核病感染的预测因素。服用 CPT（AOR=0.36；95%CI：0.21，0.62）和早期 WHO 临床分期 I 或 II（AOR=0.34；95%CI：0.20，0.56）对结核病感染有保护作用。
结论
从这项研究中可以得出结论，饮酒者、BMI<18.5kg/m、CD4 计数<499 个细胞/μl、卧床不起和活动能力以及 TB 家族史是结核病与艾滋病毒双重感染成年人的预测因素。加强更频繁的筛查、CPT 预防和及时治疗对于减少结核病合并症非常重要。
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