塔吉克斯坦重点人群中的结核病-2017 年的一个快照。

Tuberculosis in key populations in Tajikistan - a snapshot in 2017.

机构信息

Institute of Gastroenterology, Dushanbe, Tajikistan.

Tuberculosis Research and Prevention Center NGO, Yerevan, Armenia.

出版信息

J Infect Dev Ctries. 2020 Nov 16;14(11.1):94S-100S. doi: 10.3855/jidc.11952.

DOI:10.3855/jidc.11952

PMID:33226966

Abstract

INTRODUCTION

WHO End TB Strategy aims at achieving targets of 90% mortality reduction and 80% reduction in tuberculosis (TB) incidence by 2030, recommending better addressing TB and multidrug-resistant TB (MDR-TB) issues in key populations.

AIM

The study aimed at having a snapshot of the epidemiological characteristics of the key populations among the new TB patients, registered in Tajikistan during 2017.

METHODOLOGY

A cross-sectional study was conducted, using official TB registration data for all new TB case notification in Tajikistan in 2017.

RESULTS

The key population included 1,029 (19.8%) patients among all 5,182 new TB cases registered in 2017. The following selected sub-populations were identified: migrant workers - 728 (70.7%), diabetics - 162 (15.7%), HIV-positive - 138 (13.4%), heavy drinkers - 74 (7.2%), drug users - 50 (4.8%), ex-prisoners - 50 (4.8%), and homeless - 9 (0.9%). Among the key population, 307 (29.8%) patients were smear-positive, 145 (14.1%) were drug-sensitive and 116 (11.3%) had MonoDR/MDR-TB. Time to treatment initiation for smear-positive cases was ≤ 5 days for 303 (98.7%) patients. Being a key population was inversely related to gender (female) (OR = 0.25, 95% CI (0.21, 0.29)) and population type (rural) (OR = 0.64, 95% CI (0.55, 0.74)).

CONCLUSION

Among the key population the identified overlaps of selected sub-populations would enable more efficiently reaching the certain groups. TB case detection at PHC levels needs to be targeted for improved rates for key population detection. In the key population sub-group of migrant workers' special migration destinations are recommended to be explored and find out possible associations with drug resistance.

摘要

简介

世界卫生组织终结结核病策略旨在到 2030 年实现结核病死亡率降低 90%和发病率降低 80%的目标，建议更好地解决关键人群中的结核病和耐多药结核病（MDR-TB）问题。

目的

本研究旨在了解 2017 年塔吉克斯坦新登记的结核病患者中关键人群的流行病学特征。

方法

采用横断面研究方法，使用 2017 年塔吉克斯坦所有新登记的结核病病例报告的官方结核病登记数据。

结果

在 2017 年登记的 5182 例新结核病病例中，关键人群包括 1029 例（19.8%）患者。确定了以下选定的亚人群：移民工人 - 728 例（70.7%），糖尿病患者 - 162 例（15.7%），艾滋病毒阳性患者 - 138 例（13.4%），重度饮酒者 - 74 例（7.2%），吸毒者 - 50 例（4.8%），前囚犯 - 50 例（4.8%），无家可归者 - 9 例（0.9%）。在关键人群中，307 例（29.8%）患者为涂片阳性，145 例（14.1%）为药敏，116 例（11.3%）为单耐药/MDR-TB。涂片阳性病例的治疗开始时间在 5 天内的有 303 例（98.7%）。为关键人群，性别（女性）（比值比=0.25，95%置信区间（0.21，0.29））和人群类型（农村）（比值比=0.64，95%置信区间（0.55，0.74））呈负相关。