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安哥拉罗安达耐药结核病的流行病学特征和相关危险因素。

Epidemiological Characteristics and Risk Factors Related to Drug-resistant Tuberculosis in Luanda, Angola.

机构信息

Instituto Nacional de Investigação em Saúde, Luanda, Angola.

Centro de Investigação em Saúde de Angola (CISA), Caxito, Angola.

出版信息

Am J Trop Med Hyg. 2022 Jan 10;106(3):779-784. doi: 10.4269/ajtmh.21-0659.

Abstract

Tuberculosis (TB) is a major cause of illness and public health concern, especially in resource-limited countries. This study analyzed the characteristics related to anti-TB drug resistance. Moreover, we examined the evidence-based indications for the treatment of active TB in Angola. This study evaluated the medical records of 176 patients screened for TB from January to September 2016 in Luanda, the capital city of Angola. Approximately 66.5% of the patients were newly diagnosed with active TB. The residence area showed a significant relationship with TB (P = 0.025), whereas age group (P = 0.272), gender (P = 0.853), and HIV status (P = 0.284) did not showed any relationship with TB. Overall, 72.4% of TB patients had resistance to at least one of the anti-TB drugs. The risk of anti-TB drug resistance was higher in males (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 0.42-3.58, P = 0.685] and in TB-HIV coinfected patients [OR: 1.39; (95% CI: 0.26-7.28), P = 0.700], whereas it was lower in patients aged 30 years or older (OR: 0.56; 95% CI: 0.18-1.69) P = 0.303) and in patients living in urbanized areas (OR: 0.74; 95% CI: 0.17-3.25; P = 0.685). Our findings showed that drug-resistant TB is emerging in Angola. Further studies on factors related to anti-TB drug resistance are urgently needed to ascertain the magnitude of the problem and to proffer strategies toward TB control in Angola.

摘要

肺结核(TB)是导致疾病和公共卫生关注的主要原因,特别是在资源有限的国家。本研究分析了与抗结核药物耐药性相关的特征。此外,我们检查了安哥拉积极治疗结核病的循证指征。本研究评估了 2016 年 1 月至 9 月期间在安哥拉首都罗安达筛查结核病的 176 名患者的病历。约 66.5%的患者为新发活动性结核病。居住地与结核病有显著关系(P=0.025),而年龄组(P=0.272)、性别(P=0.853)和 HIV 状态(P=0.284)与结核病无任何关系。总体而言,72.4%的结核病患者对至少一种抗结核药物具有耐药性。男性(比值比[OR]:1.22;95%置信区间[CI]:0.42-3.58,P=0.685)和结核病合并 HIV 感染患者(OR:1.39;95%CI:0.26-7.28,P=0.700)的抗结核药物耐药风险更高,而 30 岁或以上患者(OR:0.56;95%CI:0.18-1.69,P=0.303)和居住在城市化地区的患者(OR:0.74;95%CI:0.17-3.25;P=0.685)的抗结核药物耐药风险较低。我们的研究结果表明,耐多药结核病正在安哥拉出现。需要进一步研究与抗结核药物耐药性相关的因素,以确定问题的严重程度,并提出安哥拉结核病控制的策略。

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