Bayissa Adamu, Demissie Meaza, Biru Mulatu, Akalu Zenebe
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.
J Clin Tuberc Other Mycobact Dis. 2022 Apr 25;27:100315. doi: 10.1016/j.jctube.2022.100315. eCollection 2022 May.
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.
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.
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.
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.
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。
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。
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。
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。