Immunology and Molecular Biology Unit, Jimma University Medical Center, Jimma, Ethiopia.
Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
PLoS One. 2022 Jan 27;17(1):e0262929. doi: 10.1371/journal.pone.0262929. eCollection 2022.
Rapid diagnosis of tuberculosis (TB) and detection of drug resistance are very important for timely and appropriate management of patients. Xpert MTB/RIF assay is approved for use in TB and rifampicin-resistance diagnosis. However, data are limited on the impact of Xpert MTB/RIF assay under routine clinical settings with a heterogeneous group of patients and sample types in Ethiopia.
A retrospective study was carried out in 2220 presumptive TB cases at Jimma University Medical Center. Data were gathered from the registration logbook using formatted data extraction tools and double entered to epidata version 3.1 and further transported to SPSS version 20 for analysis. Associations were determined using the Chi-square test and P-value <0.05 was considered statistically significant.
Of 2220 cases enrolled, 1665 (75%) were adults and the remaining 555 (25%) were children aged less than 14 years. The majority, 1964 (88.46%), had pulmonary manifestation and 256 (11.54%) had extrapulmonary involvements. The overall, frequency of Mycobacterium tuberculosis (MTB) was 9.3% (206/2220), among this 10.27% (171/1665) and 6.3% (35/555) were adults and children, respectively. M. tuberculosis was detected from 171 (8.75%) of pulmonary patients and 35 (13.28%) of extrapulmonary manifested patients. Out of 206 M. tuberculosis positive cases, 7(3.4%) were rifampicin-resistant: four from pulmonary tuberculosis (PTB) patients and three from EPTB patients. In the Chi-square test, the age group of 15-24 years, previous history of TB, pus/lymph node sample, and being HIV positive were significantly associated with TB positivity by Xpert MTB/RIF (P-value <0.001).
These data suggest that the overall frequency of M. tuberculosis and rifampicin resistance was found to be relatively low compared to the previous reports in Ethiopia. Nevertheless, better diagnostic tools and approaches are still vital to halt the burden of TB and drug-resistant TB in the country.
快速诊断结核病 (TB) 和检测耐药性对于及时、恰当地管理患者非常重要。Xpert MTB/RIF 检测法已被批准用于结核病和利福平耐药性诊断。然而，在埃塞俄比亚，在常规临床环境下，针对异质患者群体和不同类型样本，有关 Xpert MTB/RIF 检测法的影响的数据有限。
在吉姆马大学医学中心对 2220 例疑似结核病病例进行了回顾性研究。使用格式化数据提取工具从登记日志中收集数据，并将其双录入到 epidata 版本 3.1 中，然后进一步传输到 SPSS 版本 20 进行分析。使用卡方检验确定关联，P 值<0.05 被认为具有统计学意义。
在纳入的 2220 例病例中，1665 例（75%）为成年人，其余 555 例（25%）为年龄小于 14 岁的儿童。大多数患者（1964 例，88.46%）有肺部表现，256 例（11.54%）有肺外受累。总体上，结核分枝杆菌 (MTB) 的频率为 9.3%（206/2220），其中 10.27%（171/1665）和 6.3%（35/555）分别为成年人和儿童。从 171 例肺部患者和 35 例肺外表现患者中检测到 MTB。在 206 例 MTB 阳性病例中，有 7 例（3.4%）对利福平耐药：4 例来自肺结核（PTB）患者，3 例来自 EPTB 患者。在卡方检验中，15-24 岁年龄组、TB 既往史、脓液/淋巴结样本和 HIV 阳性与 Xpert MTB/RIF 检测的 TB 阳性显著相关（P 值<0.001）。
与埃塞俄比亚之前的报告相比，这些数据表明 MTB 和利福平耐药率总体上相对较低。然而，更好的诊断工具和方法对于遏制该国结核病和耐多药结核病的负担仍然至关重要。
