Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia.
TB and Leprosy Control Sector, Disease Control Division, Ministry of Health Malaysia, Putrajaya 62590, Malaysia.
Int J Environ Res Public Health. 2022 Feb 18;19(4):2365. doi: 10.3390/ijerph19042365.
Tuberculosis (TB) remains a serious public health challenge despite enormous eradication efforts. Indigenous groups worldwide have a higher TB incidence and associated delayed sputum-smear conversion. The aim of this case-control study was to determine the epidemiology and factors associated with delayed sputum-smear conversion among Malaysian aborigines.
We used secondary data from 2016 to 2020 in the MyTB surveillance system. Malaysian aborigines with smear-positive pulmonary TB were enrolled and followed until the end of the intensive phase. Descriptive statistics and multiple logistic regression were used for data analysis.
Of 725 Malaysian aborigines with pulmonary TB, 572 (78.9%) were smear-positive and 487 (78.9%) fulfilled the study criteria. The mean (SD) age of smear-positive pulmonary TB was 39.20 (16.33) years. Majority of participants were male (63%), Senoi tribe (54.9%), living in rural areas (88.1%), formally educated (60.4%) and living below the poverty line (97.1%). Overall, 93 (19.1%) of 487 patients showed delayed sputum-smear conversion and significantly associated factors, such as smoking (AdjOR: 3.25; 95% CI: 1.88, 5.59), diabetes mellitus (AdjOR: 12.84; 95% CI: 6.33, 26.06), and HIV infection (AdjOR: 9.76; 95% CI: 3.01, 31.65).
Stakeholders should adopt targeted approaches to tackle the problem of aboriginal groups with pulmonary TB and these associated risk factors to realise the End TB target.
尽管付出了巨大的努力，结核病（TB）仍然是一个严重的公共卫生挑战。全球土著群体的结核病发病率更高，相关的痰涂片转化也更延迟。本病例对照研究旨在确定马来西亚原住民中痰涂片转化延迟的流行病学和相关因素。
我们使用了 2016 年至 2020 年 MyTB 监测系统中的二级数据。纳入了痰涂片阳性的肺结核马来西亚原住民，并随访至强化期结束。采用描述性统计和多因素逻辑回归进行数据分析。
在 725 例肺结核的马来西亚原住民中，572 例（78.9%）为痰涂片阳性，487 例（78.9%）符合研究标准。痰涂片阳性肺结核的平均（SD）年龄为 39.20（16.33）岁。大多数参与者为男性（63%）、塞诺伊部落（54.9%）、居住在农村地区（88.1%）、受过正规教育（60.4%）和生活在贫困线以下（97.1%）。总的来说，487 例患者中有 93 例（19.1%）出现痰涂片转化延迟，且与显著相关的因素，如吸烟（调整比值比：3.25；95%置信区间：1.88，5.59）、糖尿病（调整比值比：12.84；95%置信区间：6.33，26.06）和 HIV 感染（调整比值比：9.76；95%置信区间：3.01，31.65）有关。
利益相关者应采取有针对性的方法来解决肺结核原住民群体及其相关风险因素的问题，以实现终止结核病目标。
