Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Cameroon.
Tuberculosis Reference Laboratory Douala, Cameroon.
Biomed Res Int. 2021 Nov 19;2021:8817442. doi: 10.1155/2021/8817442. eCollection 2021.
Multiple drug resistance TB (MDR-TB) has greatly jeopardized the effective control of tuberculosis in Africa. This study is aimed at determining the incidence and predictors of drug resistant-TB amongst bacteriologically diagnosed cases in the Littoral region of Cameroon. This was a descriptive cross-sectional survey conducted from January 2016 to December 2017. A total of 1665 participants were enrolled from 32 diagnostic and treatment centers (DTCs) in the Littoral region. Demographic, clinical, socioeconomic, and behavioral data were obtained using a pretested structured questionnaire. Drug susceptibility testing was performed using Gene Xpert MTB/RIF assay and line probe assay (LPA). Consent was obtained from participant/guidance. Data analysis was carried with SPSS version 21. Univariate and multiple logistic regression was performed at 5% significance level. The incidence of rifampicin and MDR-TB was 86 (5.2%) and 75 (4.5%), respectively. More (11.3%) cases of drug resistance were diagnosed in 2016 compared to 2017 (3.7%). Eleven (0.7%) were resistant to rifampicin only. A total of 19 (4.4%) cases of rifampicin resistance were detected from newly diagnosed cases and 67 (5.4%) from previously retreated cases. Pre-XDR-TB was detected in 2 (2.7%) of the MDR-TB cases amongst whom 1 (1.3%) was extensive drug resistance TB (XDR-TB). Age greater than 60 years old (OR = 4.98, = 0.047), being married (OR = 1.91, = 0.006), being currently incarcerated (OR = 1.74, = 0.027), and having contact with known TB cases (OR = 1.88, = 0.007) were associated to MDR-TB in a univariate analysis. This study highlights the declining rates of TB drug resistance in the region over the years probably due to the introduction of Gene Xpert that results in early detection of RR-TB. It also shows that age greater than 60 years, being married, and incarcerated are predictors of drug resistant-TB, while the year of patient enrolment and previous exposure to TB treatment were independent predictors of drug resistance in the Littoral region of Cameroon.
耐多药结核病（MDR-TB）极大地危及了非洲结核病的有效控制。本研究旨在确定喀麦隆滨海地区细菌学诊断病例中耐药结核病的发生率和预测因素。这是一项描述性的横断面研究，于 2016 年 1 月至 2017 年 12 月进行。从滨海地区的 32 个诊断和治疗中心（DTC）共招募了 1665 名参与者。使用经过预测试的结构化问卷获得人口统计学、临床、社会经济和行为数据。使用 Gene Xpert MTB/RIF 检测和线探针检测（LPA）进行药物敏感性检测。从参与者/指导获得同意。使用 SPSS 版本 21 进行数据分析。在 5%的显著性水平下进行单变量和多变量逻辑回归分析。利福平的发生率和 MDR-TB 分别为 86（5.2%）和 75（4.5%）。与 2017 年相比，2016 年诊断出更多（11.3%）的耐药病例。总共在新诊断病例中发现了 19 例（4.4%）利福平耐药病例，在以前治疗过的病例中发现了 67 例（5.4%）。在 MDR-TB 病例中检测到 2 例（2.7%）耐利福平的病例，其中 1 例（1.3%）为广泛耐药结核病（XDR-TB）。年龄大于 60 岁（OR=4.98， = 0.047）、已婚（OR=1.91， = 0.006）、目前监禁（OR=1.74， = 0.027）和接触已知的结核病例（OR=1.88， = 0.007）在单变量分析中与 MDR-TB 相关。本研究强调了该地区多年来结核病耐药率的下降趋势，这可能是由于引入了 Gene Xpert，从而早期发现 RR-TB。它还表明，年龄大于 60 岁、已婚和监禁是耐药结核病的预测因素，而患者入组年份和以前接受过结核病治疗是喀麦隆滨海地区耐药的独立预测因素。
