中非共和国耐多药结核病的危险因素：一项病例对照研究。

Risk factors for multidrug-resistant tuberculosis in the Central African Republic: A case-control study.

机构信息

National Reference Centre for Sexually Transmitted Diseases and Antiretroviral Therapy, Bangui, Central African Republic; Unit for Research and Intervention in Public Health, Department of Public Health, Faculty of Health Sciences, Bangui, Central African Republic.

Unit for Research and Intervention in Public Health, Department of Public Health, Faculty of Health Sciences, Bangui, Central African Republic; Communicable Diseases Unit, Inter-State Centre for Higher Education in Public Health of Central Africa, Brazzaville, Congo.

出版信息

J Infect Public Health. 2023 Sep;16(9):1341-1345. doi: 10.1016/j.jiph.2023.06.007. Epub 2023 Jun 13.

DOI:10.1016/j.jiph.2023.06.007

PMID:37437428

Abstract

BACKGROUND

The emergence and spread of multidrug-resistant tuberculosis (MDR-TB) presents a challenge to the "End TB by 2035" strategy. This study aimed to identify the risk factors associated with MDR-TB in patients admitted to the pneumo-physiology clinic of the National University Hospital of Bangui in Central African Republic.

METHODS

This was a "retrospective" chart review study. Cases were represented by patients more than 18 years of age treated for MDR-TB and controls were patients with "at least rifampicin-susceptible" TB treated "with first-line anti-TB regimen" and who at the end of treatment were declared cured. The status of "cured" was exclusively applicable to non-MDR TB. Risk factors associated with MDR-TB were identified by multivariate analysis.

RESULTS

We included 70 cases and 140 controls. The median age was 35 years, IQR (22;46 years). The main factors associated with the occurrence of MDR-TB in multivariate analysis were male gender (0 R = 3.02 [1.89-3.99], p = 0.001), residence in a peri-urban/urban area (0 R = 3.06 [2.21-4.01], p = 0.002), history of previous TB treatment (0 R= 3.99 [2.77-4.25], p < 0.001) and the presence of multidrug-resistant TB in the family (0 R=1.86 [1.27-2.45], p = 0.021).

CONCLUSION

The emergence of MDR-TB can be reduced by implementing appropriate strategies, such as preventive therapy in contacts of MDR-TB patients and detecting and appropriately treating MDR-TB patients to prevent further spread of infection.

摘要

背景

耐多药结核病（MDR-TB）的出现和传播对“2035 年终结结核病”战略构成了挑战。本研究旨在确定中非共和国国家大学医院呼吸生理科收治的 MDR-TB 患者的相关风险因素。

方法

这是一项“回顾性”图表回顾研究。病例组为年龄超过 18 岁的 MDR-TB 治疗患者，对照组为接受“一线抗结核方案”治疗的“至少利福平敏感”TB 患者，在治疗结束时被宣布治愈。“治愈”状态仅适用于非 MDR-TB。通过多变量分析确定与 MDR-TB 相关的风险因素。

结果

我们纳入了 70 例病例和 140 例对照。中位年龄为 35 岁，IQR（22；46 岁）。多变量分析中与 MDR-TB 发生相关的主要因素为男性（0R=3.02[1.89-3.99]，p=0.001）、居住在城市周边/城市地区（0R=3.06[2.21-4.01]，p=0.002）、既往 TB 治疗史（0R=3.99[2.77-4.25]，p<0.001）和家庭中存在 MDR-TB（0R=1.86[1.27-2.45]，p=0.021）。