埃塞俄比亚东部成年涂片阳性肺结核患者的多重耐药程度及相关因素
Magnitude of Multidrug Resistance and Associated Factors of Pulmonary Tuberculosis Among Adult Smear Positive Patients in Eastern Ethiopia.
作者信息
Amin Ziad, Mitiku Habtamu, Marami Dadi, Shume Tadesse, Weldegebreal Fitsum
机构信息
Harari Health Research and Regional Laboratory, Harar, Ethiopia.
Department of Medical Laboratory Sciences, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.
出版信息
Infect Drug Resist. 2021 Oct 28;14:4493-4500. doi: 10.2147/IDR.S326798. eCollection 2021.
BACKGROUND
In Ethiopia, multidrug resistant tuberculosis is a major public health problem. However, information is scarce regarding MDR-TB and associated factors.
OBJECTIVE
The study was aimed to assess the magnitude of multidrug resistance and associated factors of pulmonary tuberculosis among adult smear-positive patients in Harari regional state health facilities, eastern Ethiopia.
METHODS
A cross-sectional study was conducted among 395 adult smear-positive pulmonary tuberculosis patients attending health facilities from March to October 2019. Smear-positive sputum samples were collected from health facilities, and transported to Harari Health Research and Regional Laboratory, and tested for drug susceptibility using a line probe assay. Data were analyzed using Statistical Package for Social Sciences version 20. Bivariate and multivariable logistic regression analyses with 95% confidence intervals were carried out to identify factors associated with multidrug-resistant tuberculosis.
RESULTS
The overall magnitude of multidrug-resistant tuberculosis was 3.8% (15/395) (95% CI: 2.0-5.8%). Being male (AOR = 4.9; 95% CI: 1.16, 20.5), patients with a previous history of tuberculosis (AOR = 4.9; 95% CI: 1.5, 29.6), treatment failure (AOR = 8.5; 95% CI: 1.61, 45.3), treatment default (AOR = 10.38; 95% CI: 1.86, 58.0), human immunodeficiency virus co-infection (AOR = 9.83.95% CI: 3, 21, 30.1) and a previous history of contact with multidrug-resistant tuberculosis patients (AOR = 14.4; 95% CI: 3.1, 67.6) had higher odds of multidrug-resistant tuberculosis.
CONCLUSION
The overall magnitude of multidrug-resistant tuberculosis was high. Strengthening the tuberculosis control program by giving special attention to HIV co-infected patients, treatment failure and default, previously infected patients as well as to those individuals who have a history of contact with multidrug-resistant tuberculosis infected patients .
背景
在埃塞俄比亚，耐多药结核病是一个重大的公共卫生问题。然而，关于耐多药结核病及其相关因素的信息却很匮乏。
目的
本研究旨在评估埃塞俄比亚东部哈拉里地区州卫生设施中成年涂片阳性患者耐多药情况及其相关因素。
方法
2019年3月至10月，对395名到卫生设施就诊的成年涂片阳性肺结核患者进行了一项横断面研究。从卫生设施收集涂片阳性痰标本，并运至哈拉里卫生研究与区域实验室，采用线性探针分析法检测药物敏感性。使用社会科学统计软件包第20版进行数据分析。进行了双变量和多变量逻辑回归分析，并给出95%置信区间，以确定与耐多药结核病相关的因素。
结果
耐多药结核病的总体比例为3.8%（15/395）（95%置信区间：2.0 - 5.8%）。男性（调整后比值比[AOR]=4.9；95%置信区间：1.16，20.5）、有结核病既往史的患者（AOR = 4.9；95%置信区间：1.5，29.6）、治疗失败的患者（AOR = 8.5；95%置信区间：1.61，45.3）、治疗中断的患者（AOR = 10.38；95%置信区间：1.86，58.0）、人类免疫缺陷病毒合并感染患者（AOR = 9.83；95%置信区间：3.21，30.1）以及有耐多药结核病患者接触史的患者（AOR = 14.4；95%置信区间：3.1，67.6）患耐多药结核病的几率更高。
结论
耐多药结核病的总体比例较高。应特别关注合并感染艾滋病毒的患者、治疗失败和中断的患者、既往感染过结核病的患者以及有耐多药结核病患者接触史的个体，以加强结核病控制项目。
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