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缅甸东北部农村人口的结核感染率及其决定因素。

Prevalence and determinants of TB infection in a rural population in northeastern Myanmar.

机构信息

School of Health Science, Mae Fah Lunag University, Chiang Rai, 57100, Thailand.

Center of Excellence for Hill Tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand.

出版信息

BMC Infect Dis. 2020 Nov 30;20(1):904. doi: 10.1186/s12879-020-05646-8.

Abstract

BACKGROUND

Tuberculosis (TB) is a major human threat, as evidenced by the large numbers of cases and deaths, particularly in developing countries with poor economic and educational statuses. Myanmar has one of the highest TB burdens in the world, but no TB information is available for people living in the rural northeastern regions of Myanmar. The present study estimated the prevalence of TB and identified factors associated with TB infection in people living in rural communities in Shan State.

METHODS

A cross-sectional study was performed to gather information from participants. People aged 18-59 years who lived in the three areas with the highest numbers of TB cases in Shan State in northeastern Myanmar were included in the study population. A simple random method was used to select the sample from the villages. A validated questionnaire was used for data collection in face-to-face interviews after obtaining signed informed consent from the selected participants. The Mantoux tuberculin skin test (TST) was administered to detect TB infection, and a result that was 10 mm or greater after 48 h was considered positive. Chi-squared tests and logistic regression were used to identify the associations between the variables at a significance level of α = 0.05.

RESULTS

A total of 303 participants were recruited for the study; 64.7% were females, and the mean age was 37 years (SD = 12.5). Most participants were Burmese (25.4%), and 14.95% were Shan. Sixty-three participants (20.8%) had a positive TST. Four variables were associated with TB infection in the multivariate model. Males had a greater chance of TB infection than females (AOR = 2.51; 95% CI = 1.32-4.76). Participants who were ever married had a greater chance of TB infection than participants who were single (AOR = 3.93; 95% CI = 1.18-13.00). Participants who used wood and charcoal as their main sources of energy for cooking had a greater chance of TB infection than participants who used electricity (AOR = 4.23; 95% CI = 1.25-9.64). Participants who had a low level of TB prevention and care knowledge had a greater chance of TB infection than participants with a high level of TB prevention and care knowledge (AOR = 4.49; 95% CI = 1.88-10.72).

CONCLUSIONS

Public health programs that focus on improving knowledge of TB prevention and care and avoiding the use of wood and charcoal as the primary sources of energy for cooking, particularly in males and ever-married individuals, are urgently needed.

摘要

背景

结核病(TB)是人类面临的主要威胁,大量的病例和死亡人数就证明了这一点,特别是在经济和教育状况较差的发展中国家。缅甸是世界上结核病负担最重的国家之一,但缅甸东北部农村地区的人们没有结核病信息。本研究旨在估计缅甸掸邦农村社区人群中结核病的患病率,并确定与结核病感染相关的因素。

方法

采用横断面研究方法收集参与者信息。研究人群为缅甸东北部掸邦三个结核病病例最多地区的 18-59 岁人群。采用简单随机方法从村庄中抽取样本。在获得选定参与者的书面知情同意后,使用经过验证的问卷进行面对面访谈以收集数据。采用结核菌素皮肤试验(TST)检测结核病感染,硬结直径 10 毫米或以上者视为阳性。采用卡方检验和 logistic 回归分析在显著性水平 α=0.05 下对变量之间的关联进行分析。

结果

共招募了 303 名参与者进行研究;64.7%为女性,平均年龄为 37 岁(SD=12.5)。大多数参与者为缅甸人(25.4%),14.95%为掸邦人。63 名参与者(20.8%)的 TST 阳性。多变量模型中有四个变量与结核病感染相关。男性比女性更容易感染结核病(AOR=2.51;95%CI=1.32-4.76)。已婚参与者比单身参与者更容易感染结核病(AOR=3.93;95%CI=1.18-13.00)。主要使用木材和木炭作为烹饪燃料的参与者比主要使用电力的参与者更容易感染结核病(AOR=4.23;95%CI=1.25-9.64)。结核病预防和护理知识水平低的参与者比结核病预防和护理知识水平高的参与者更容易感染结核病(AOR=4.49;95%CI=1.88-10.72)。

结论

迫切需要开展公共卫生项目,重点提高结核病预防和护理知识,避免使用木材和木炭作为烹饪的主要燃料,特别是针对男性和已婚人群。

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