Department of Medical Microbiology and Immunology, School of Medicine, Mekelle University, Mekelle, Ethiopia.
Department of Medical Microbiology and Immunology, School of Medicine, Aksum University, Aksum, Ethiopia.
PLoS One. 2020 Nov 4;15(11):e0240361. doi: 10.1371/journal.pone.0240361. eCollection 2020.
Multidrug-resistant tuberculosis (MDR-TB) continues to be a global health problem. Data on rifampicin resistance MTB using Xpert- MTB/RIF assay in Ethiopia, particularly in the study area is limited. The aim of this study was to determine the frequency of MTB and rifampicin resistant-MTB among presumptive tuberculosis patients in Tigray, Northern Ethiopia.
A multicenter retrospective study was conducted among presumptive TB patients from five governmental hospitals and one comprehensive specialized teaching hospital in Tigray regional state. Records of sputum sample results of presumptive MTB patients with Xpert-MTB/RIF assay from January 2016 to December 2019 were investigated. Data extraction tool was used to collect data from registration books and analyzed using SPSS ver.21 statistical software. Statistical significance was set at p-value ≤ 0.05.
Of the 30,935 presumptive adult TB patients who have provided specimens for TB diagnosis from January 2016 to December 2019, 30,300 (98%) had complete data and were included in this study. More than half, 17,471 (57.7%) were males, and the age of the patients ranged from 18-112 years, with a median age of 40.65 (interquartile 29.4-56.5 years). Majority, 28,996 (95.7%) of the participants were treatment naïve, and 23,965 (79.1%) were with unknown HIV status. The overall frequency of MTB was 2,387 (7.9% (95% CI: 7.6-8.2%); of these, 215 (9% (95% CI: 7.9-10.2%) were rifampicin resistant-MTB. Age (18-29 years), HIV positive and previous TB treatment history were significantly associated with high MTB (p < 0.001), whereas gender (being female) was associated with low MTB (p < 0.001). Likewise, rifampicin resistant-MTB was more prevalent among relapse (p < 0.001) and failure cases (p = 0.025); while age group 30-39 years was significantly associated with lower frequency of rifampicin resistant-MTB (p = 0.008).
Frequency of MTB among tuberculosis presumptive patients was low; however, the problem of rifampicin resistant-MTB among the tuberculosis confirmed patients was high. The high frequency of MTB and RR-MTB among previously treated and HIV positive patients highlights the need for more efforts in TB treatment and monitoring program in the study area.
耐多药结核病（MDR-TB）仍然是一个全球性的健康问题。在埃塞俄比亚，特别是在研究区域，使用 Xpert-MTB/RIF 检测耐利福平结核分枝杆菌的数据有限。本研究的目的是确定提格雷州北部的疑似结核病患者中结核分枝杆菌和耐利福平结核分枝杆菌的频率。
这是一项多中心回顾性研究，对来自提格雷州五个政府医院和一个综合专门教学医院的疑似结核病患者进行了研究。调查了 2016 年 1 月至 2019 年 12 月期间使用 Xpert-MTB/RIF 检测疑似结核分枝杆菌患者的痰样本结果。使用数据提取工具从登记册中收集数据，并使用 SPSS ver.21 统计软件进行分析。统计显著性设为 p 值≤0.05。
在 2016 年 1 月至 2019 年 12 月期间提供结核病诊断样本的 30935 名疑似成人结核病患者中，有 30300 名（98%）有完整的数据，并纳入了本研究。超过一半，17471 名（57.7%）为男性，患者年龄为 18-112 岁，中位数年龄为 40.65 岁（四分位间距 29.4-56.5 岁）。大多数参与者，28996 名（95.7%）为初次治疗患者，23965 名（79.1%）为未知 HIV 状况。结核分枝杆菌的总频率为 2387 例（7.9%（95%CI：7.6-8.2%）；其中，215 例（9%（95%CI：7.9-10.2%）为耐利福平结核分枝杆菌。年龄（18-29 岁）、HIV 阳性和既往结核病治疗史与结核分枝杆菌高发生率显著相关（p<0.001），而性别（女性）与结核分枝杆菌低发生率相关（p<0.001）。同样，耐利福平结核分枝杆菌在复发（p<0.001）和失败病例中更为普遍（p=0.025）；而 30-39 岁年龄组与耐利福平结核分枝杆菌的低频率显著相关（p=0.008）。
疑似结核病患者中结核分枝杆菌的发生率较低；然而，确诊结核病患者中耐利福平结核分枝杆菌的问题很高。既往治疗和 HIV 阳性患者中结核分枝杆菌和 RR-MTB 的高发生率突出表明，需要在研究区域加强结核病治疗和监测方案。
