Diriba Kuma, Awulachew Ephrem
Department of Medical Laboratory Sciences, Health Science and Medical College, Dilla University, Dilla, Ethiopia.
SAGE Open Med. 2022 Mar 25;10:20503121221086725. doi: 10.1177/20503121221086725. eCollection 2022.
Tuberculosis remains a major global health problem causing death among millions of people each year. Even though many of the World Health Organization recommended tuberculosis control strategies were implemented, there is still a major gap in tuberculosis case detection and treatment which resulted in rapid transmission of the cases in high burden countries. This study aimed to provide updated information on the contributing factors for the development of tuberculosis.
A case-control study was carried out in Gedeo Zone from February to July 2021 to assess the risk factors of tuberculosis. Cases were confirmed pulmonary tuberculosis patients with age ⩾18 years, while controls were participants who were confirmed to be pulmonary tuberculosis negative with the same age. Multivariate logistic regression models were used to assess the associated risk factor.
A total of 368 individuals (173 cases and 173 controls) were included in this study. Based on the multivariable logistic regression analysis, we identified six variables as independent risk factors for the development of tuberculosis after controlling possible confounders. Those were patients with income <1500 Ethiopian birr per month (adjusted odds ratio = 2.35; 95% confidence interval: 1.22-3.97), patients with no educational background (illiterate) (adjusted odds ratio = 2.10; 95% confidence interval: 1.17-2.51), patients smoking cigarette (adjusted odds ratio = 2.89; 95% confidence interval: 2.10-3.82), patients chewing khat (adjusted odds ratio = 2.86; 95% confidence interval: 1.28-3.79), patients in close contact with known tuberculosis cases (adjusted odds ratio = 3.63; 95% confidence interval: 2.24-4.46), and patients being positive for HIV (adjusted odds ratio = 3.01; 95% confidence interval: 1.07-3.52) who were found to be significantly associated with tuberculosis development, while Bacille Calmette-Guérin vaccination had a protective effect against the development of tuberculosis (adjusted odds ratio = 0.52; 95% confidence interval: 0.21-0.88).
The priority should be given to the identified contributing factors through application of coordinated efforts on screening of patients suspected for pulmonary tuberculosis and all contacts of pulmonary tuberculosis patients and treatment of known tuberculosis cases, and appropriate control methods to reduce cases.
结核病仍然是一个重大的全球健康问题,每年导致数百万人死亡。尽管世界卫生组织推荐的许多结核病控制策略已得到实施,但在结核病病例检测和治疗方面仍存在重大差距,这导致高负担国家的病例迅速传播。本研究旨在提供有关结核病发生的影响因素的最新信息。
2021年2月至7月在格迪奥地区开展了一项病例对照研究,以评估结核病的危险因素。病例为年龄≥18岁的确诊肺结核患者,对照为年龄相同、确诊为肺结核阴性的参与者。采用多变量逻辑回归模型评估相关危险因素。
本研究共纳入368人(173例病例和173例对照)。基于多变量逻辑回归分析,在控制了可能的混杂因素后,我们确定了六个变量为结核病发生的独立危险因素。这些因素包括月收入低于1500埃塞俄比亚比尔的患者(调整后的优势比=2.35;95%置信区间:1.22-3.97)、无教育背景(文盲)的患者(调整后的优势比=2.10;95%置信区间:1.17-2.51)、吸烟的患者(调整后的优势比=2.89;95%置信区间:2.10-3.82)、咀嚼恰特草的患者(调整后的优势比=2.86;95%置信区间:1.28-3.79)与已知结核病病例密切接触的患者(调整后的优势比=3.63;95%置信区间:2.24-4.46)以及HIV检测呈阳性的患者(调整后的优势比=3.01;95%置信区间:1.07-3.52),这些因素被发现与结核病的发生显著相关,而卡介苗接种对结核病的发生具有保护作用(调整后的优势比=0.52;95%置信区间:0.21-0.88)。
应通过协调努力,对疑似肺结核患者和所有肺结核患者的接触者进行筛查,对已知结核病病例进行治疗,并采取适当的控制措施以减少病例,优先关注已确定的影响因素。