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埃塞俄比亚耐多药结核病患者中初始耐药的比例及趋势

Proportion and trend of primary resistance among Multidrug resistant Tuberculosis patients in Ethiopia.

作者信息

Bayissa Adamu, Demissie Meaza, Biru Mulatu, Akalu Zenebe

机构信息

Armauer Hansen Research Institute, Jimma Road, ALERT Compound, P.O.Box 1005, Addis Ababa, Ethiopia.

Addis Continental Institute of Public Health, P.O.Box 27751/1000, Addis Ababa, Ethiopia.

出版信息

J Clin Tuberc Other Mycobact Dis. 2022 Apr 25;27:100315. doi: 10.1016/j.jctube.2022.100315. eCollection 2022 May.

Abstract

BACKGROUND

Evidence based information on the proportion & trend of primary resistance among multidrug resistance (MDR) TB patients is important for designing effective strategies in the control of the disease.

METHODS

A retrospective record review of 348 MDR/RR-TB patients treated at All African Leprosy Rehabilitation & Training (ALERT) Center from January 2014- December 2018. Categorical variables were compared using Chi-square/Fisher exact test as appropriate. Trend analysis was done using chi-square & linear regression. Logistic regression analysis was done to determine the factors associated with primary MDR/RR TB. Adjusted Odds Ratio (AOR) with 95% CI and p value < 5% were used to report factors associated.

RESULT

Proportion of primary resistance among MDR/RR TB patients was 25.9% with 95% CI 21.3-30.3%. The proportion increased form 9.7% in 2014 to 43.4% in 2018 at a yearly increasing rate of 9.27%. Contact history to TB patient & year of diagnosis 2017 and 2018 were significantly associated with primary resistance AOR (95% CI) & p value 4.15(1.75-9.84) p = 0.001, 3.87(1.44-10.39) p = 0.007, 3.43(1.20-9.84) p = 0.022 respectively.

CONCLUSION

The study revealed a high proportion of primary resistance among MDR/RR TB during the study period with a linearly increasing fashion thus a need for due attention in the efforts to control MDR TB.

摘要

背景

关于耐多药结核病(MDR-TB)患者中初始耐药的比例及趋势的循证信息,对于制定有效的疾病控制策略至关重要。

方法

对2014年1月至2018年12月在全非洲麻风病康复与培训(ALERT)中心接受治疗的348例耐多药/利福平耐药结核病(MDR/RR-TB)患者进行回顾性记录审查。分类变量在适当情况下使用卡方检验/费舍尔精确检验进行比较。趋势分析采用卡方检验和线性回归。进行逻辑回归分析以确定与初始耐多药/利福平耐药结核病相关的因素。使用调整后的优势比(AOR)及95%置信区间和p值<5%来报告相关因素。

结果

耐多药/利福平耐药结核病患者中初始耐药的比例为25.9%,95%置信区间为21.3 - 30.3%。该比例从2014年的9.7%增至2018年的43.4%,年增长率为9.27%。与结核病患者的接触史以及2017年和2018年的诊断年份与初始耐药显著相关,AOR(95%置信区间)及p值分别为4.15(1.75 - 9.84),p = 0.001;3.87(1.44 - 10.39),p = 0.007;3.43(1.20 - 9.84),p = 0.022。

结论

该研究揭示了在研究期间耐多药/利福平耐药结核病患者中初始耐药比例较高且呈线性上升趋势,因此在耐多药结核病控制工作中需要予以充分关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f43/9062340/a72140b0e046/gr1.jpg

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