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埃塞俄比亚阿达玛市结核性淋巴结炎的严重程度、危险因素和利福平耐药性:一项横断面研究。

Magnitude of tuberculosis lymphadenitis, risk factors, and rifampicin resistance at Adama city, Ethiopia: a cross-sectional study.

机构信息

Department of Laboratory, Adama Hospital Medical College, Adama, Ethiopia.

School of Medical Laboratory Science, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia.

出版信息

Sci Rep. 2023 Sep 24;13(1):15955. doi: 10.1038/s41598-023-43206-7.

Abstract

Mycobacterium tuberculosis complex has an impact on public health and is responsible for over one million deaths per year. Substantial numbers of people infected with M. tuberculosis can develop tuberculosis lymphadenitis; however, there is a limited study in Adama, Ethiopia. The aim of this study was to determine the magnitude of Tuberculosis lymphadenitis, its predictors, and rifampicin-resistance gene-positive M. tuberculosis. A total of 291 patients with enlarged lymph nodes were recruited from May 2022 to August 30 at Adama Comprehensive Specialized Hospital Medical College (ACSHMC). GeneXpert, Ziehl-Neelsen staining, and cytology were used for the diagnosis of TB lymphadenitis from the Fine Needle Aspirate (FNA) specimen. Rifampicin-resistant gene was detected using GeneXpert. For data entry and analysis, Epi Data version 3.0 and SPSS version 25 were used respectively. A binary logistic regression model was used to identify predictors of TB lymphadenitis. A p < 0.05 with a 95% confidence interval (CI) was taken as a cut point to determine the significant association between dependent and independent variables. The prevalence of TB lymphadenitis using GeneXpert, Ziehl-Neelsen staining, and cytology were 138 (47.4%) (95% CI 41.70-53.10), 100 (34.4%) (95% CI 28.94-39.85), and 123 (42.3%) (95% CI 36.63-47.00) respectively. Nine (3.1%) participants were infected with rifampicin-resistant gene-positive M. tuberculosis. Out of the total M. tuberculosis detected by GeneXpert (n = 138), 9 (6.5%) were positive for rifampicin resistance-gene. Participants with a chronic cough had 2 times odds of developing TB lymphadenitis (AOR: 2.001, 95% CI 1.142-3.508). Close to half of patients with enlarged lymph nodes were positive for M. tuberculosis by the GeneXpert method in the study area. Chronic cough was significantly associated with TB lymphadenitis. Rifampicin-resistant gene-positive M. tuberculosis was relatively prevalent among patients with enlarged lymph node in the study area.

摘要

结核分枝杆菌复合体对公共卫生有影响,每年导致超过 100 万人死亡。大量感染结核分枝杆菌的人可能会发展为结核性淋巴结炎;然而,在埃塞俄比亚的阿达玛,对其的研究有限。本研究旨在确定结核性淋巴结炎的严重程度、其预测因素以及利福平耐药基因阳性结核分枝杆菌。2022 年 5 月至 8 月 30 日,共从阿达玛综合专科医院医学院(ACSHMC)招募了 291 名淋巴结肿大的患者。GeneXpert、Ziehl-Neelsen 染色和细胞学用于从细针抽吸(FNA)标本中诊断结核性淋巴结炎。使用 GeneXpert 检测利福平耐药基因。Epi Data 版本 3.0 和 SPSS 版本 25 分别用于数据输入和分析。使用二项逻辑回归模型来确定结核性淋巴结炎的预测因素。p<0.05,95%置信区间(CI)为 0.05 作为确定因变量和自变量之间显著关联的截止点。使用 GeneXpert、Ziehl-Neelsen 染色和细胞学检测结核性淋巴结炎的患病率分别为 138 例(47.4%)(95%CI 41.70-53.10)、100 例(34.4%)(95%CI 28.94-39.85)和 123 例(42.3%)(95%CI 36.63-47.00)。9 名(3.1%)参与者感染了利福平耐药基因阳性结核分枝杆菌。在通过 GeneXpert 检测到的结核分枝杆菌总数(n=138)中,有 9 名(6.5%)对利福平耐药基因呈阳性。有慢性咳嗽的参与者发生结核性淋巴结炎的几率是两倍(AOR:2.001,95%CI 1.142-3.508)。在研究区域,近一半的淋巴结肿大患者通过 GeneXpert 方法检测出结核分枝杆菌呈阳性。慢性咳嗽与结核性淋巴结炎显著相关。在研究区域,利福平耐药基因阳性结核分枝杆菌在淋巴结肿大患者中较为普遍。

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