Ali Mohamed Muhumed, Weldegebreal Fitsum, Kabew Getachew, Urgesa Kedir
College of Health and Medical Sciences of Daha International University, Mogadishu, Somalia.
Department of Medical Laboratory Sciences College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
SAGE Open Med. 2023 Jan 10;11:20503121221148603. doi: 10.1177/20503121221148603. eCollection 2023.
Multi-drug resistant is a growing public health problem in developing countries including Somalia. Although, the prevalence of multi-drug resistant tuberculosis among new and retreated cases is high, data on GeneXpert- /rifampicin-resistant assay, which is a surrogate marker for multidrug resistance, is not well explored in Mogadishu.
To determine the prevalence of rifampicin-resistant and its associated factors among presumptive pulmonary tuberculosis patients visiting tuberculosis centers in Mogadishu, Somalia.
A multicenter cross-sectional study was conducted in three tuberculosis treatment centers from March 12 to April 30, 2021. Laboratory professionals collected sputum sample consecutively from presumptive pulmonary tuberculosis participants and performed a GeneXpert assay to determine the rifampicin resistance. Socio-demographic and clinical data were collected using structured questionnaire. Logistic regression analyses were performed to assess factors associated with rifampicin resistance using an adjusted odds ratio at a 95% confidence interval. Statistical significance was considered at a -value of less than 0.05.
A total of 370 presumptive tuberculosis suspects were included; of whom 58.4% were females and the mean age of the participants was 44.3 ± 14 years. was detected in 63 (17%) (95% confidence interval = 13.2-20.8) suspects. Of these the prevalence of rifampicin-resistant was 35% (95% confidence interval = 30.2-39.8). Anti-tuberculosis treatment history (adjusted odds ratio = 4.1; 95% confidence interval = 1.91-6.75), monthly income less than $100 USD (adjusted odds ratio = 2.2; 95% confidence interval = 1.77-5.98) and being diagnosed with Asthma (adjusted odds ratio = 2.63; 95% confidence interval = 1.3-7.3) were significantly associated with rifampicin-resistant tuberculosis.
A considerable proportion of rifampicin-resistant tuberculosis is reported in these study settings. The strong association between multidrug resistance tuberculosis and patients' retreatment history of tuberculosis, low income, and co-morbidity with asthma highlights the need for more efforts in tuberculosis treatment and monitoring programs to limit the emergence of multi-drug resistant strain in the study areas.
在包括索马里在内的发展中国家，多重耐药是一个日益严重的公共卫生问题。尽管新发病例和复治病例中多重耐药结核病的患病率很高，但在摩加迪沙，关于作为多重耐药替代标志物的GeneXpert/利福平耐药检测的数据尚未得到充分研究。
确定在索马里摩加迪沙结核病中心就诊的疑似肺结核患者中利福平耐药的患病率及其相关因素。
2021年3月12日至4月30日，在三个结核病治疗中心进行了一项多中心横断面研究。实验室专业人员连续从疑似肺结核参与者中采集痰样本，并进行GeneXpert检测以确定利福平耐药情况。使用结构化问卷收集社会人口统计学和临床数据。进行逻辑回归分析，以95%置信区间的调整比值比评估与利福平耐药相关的因素。当P值小于0.05时认为具有统计学意义。
共纳入370名疑似结核病患者；其中58.4%为女性，参与者的平均年龄为44.3±14岁。在63名（17%）（95%置信区间=13.2-20.8）患者中检测到（利福平耐药）。其中利福平耐药的患病率为35%（95%置信区间=30.2-39.8）。抗结核治疗史（调整比值比=4.1；95%置信区间=1.91-6.75）、月收入低于100美元（调整比值比=2.2；95%置信区间=1.77-5.98）以及被诊断为哮喘（调整比值比=2.63；95%置信区间=1.3-7.3）与利福平耐药结核病显著相关。
在这些研究环境中报告了相当比例的利福平耐药结核病。多重耐药结核病与患者的结核病复治史、低收入以及合并哮喘之间的密切关联凸显了在结核病治疗和监测项目中需要做出更多努力，以限制研究地区多重耐药菌株的出现。
