Dejene Tsehaye Asmelash, Hailu Genet Gebrehiwet, Kahsay Atsebaha Gebrekidan, Wasihun Araya Gebreyesus
Department of Medical Microbiology and Immunology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Department of Medical Microbiology, School of Medicine, Aksum University, Axum, Ethiopia.
Infect Drug Resist. 2023 Oct 19;16:6757-6765. doi: 10.2147/IDR.S433789. eCollection 2023.
Tuberculosis (TB) continues to be a global health problem. While childhood TB contributes 10% to the global TB burden, the paucibacillary nature of TB disease in children and the absence of reliable diagnostic methods have made MTB diagnosis in children to be a great challenge. This study aimed to determine the prevalence of MTB and rifampicin-resistant MTB (RR-MTB) among children using Gene Xpert MTB/RIF Assay in Tigray, Ethiopia.
A retrospective database study was conducted among children in ten governmental hospitals in the Tigray region. Gene Xpert MTB/RIF results of sputum/gastric lavage samples from children with presumptive TB from January 2016 to December 2019 were extracted using a data extraction sheet. Data were collected and analyzed using Statistical Package for the Social Sciences version 21.
The prevalence of bacteriologically confirmed MTB by Gene-Xpert in children with presumptive TB was 7.3% (95% CI: 6.7%-7.9%) and the proportion of those that were Gene-Xpert MTB positive who also have rifampicin resistance was 10.9% (95% CI: 8.2-13.6%). Older children aged 11-15 years [AOR = 1.76; 95% CI = 1.33-2.33, p < 0.001] and adolescents 16-17 years [AOR = 2.18; 95% CI = 1.63-2.92, p < 0.001] were more likely to be MTB positive. Relapse cases [AOR = 1.66; 95% CI = 1.09-2.51, p = 0.017] and lost/failure cases [AOR = 8.82; 95% CI = 3.94-19.76, p < 0.001] were more likely to have MTB compared to the new cases.
The proportion of MTB-positive among the TB presumptive patients was 7.3%. The proportion of rifampicin-resistant TB to all positive patients was 10.9%. Female participants had more MTB than males (or younger children). The result highlights the need for due attention in children because it is very helpful in determining the future control of the disease.
结核病仍然是一个全球性的健康问题。虽然儿童结核病占全球结核病负担的10%，但儿童结核病的少菌性以及缺乏可靠的诊断方法，使得儿童结核分枝杆菌（MTB）的诊断成为一项巨大挑战。本研究旨在通过基因Xpert MTB/RIF检测法确定埃塞俄比亚提格雷地区儿童中MTB和耐利福平MTB（RR-MTB）的患病率。
在提格雷地区的十家政府医院对儿童进行了一项回顾性数据库研究。使用数据提取表提取2016年1月至2019年12月疑似结核病儿童的痰液/洗胃样本的基因Xpert MTB/RIF检测结果。使用社会科学统计软件包第21版收集和分析数据。
通过基因Xpert检测确诊的疑似结核病儿童中MTB的患病率为7.3%（95%置信区间：6.7%-7.9%），基因Xpert MTB检测呈阳性且同时耐利福平的比例为10.9%（95%置信区间：8.2%-13.6%）。11至15岁的大龄儿童[AOR = 1.76；95%置信区间 = 1.33-2.33，p < 0.001]和16至17岁的青少年[AOR = 2.18；95%置信区间 = 1.63-2.92，p < 0.001]MTB检测呈阳性的可能性更高。与新发病例相比，复发病例[AOR = 1.66；95%置信区间 = 1.09-2.51，p = 0.017]和丢失/治疗失败病例[AOR = 8.82；95%置信区间 = 3.94-19.76，p < 0.001]更有可能感染MTB。
疑似结核病患者中MTB检测呈阳性的比例为7.3%。耐利福平结核病在所有阳性患者中的比例为10.9%。女性参与者的MTB感染率高于男性（或年幼儿童）。该结果凸显了对儿童给予适当关注的必要性，因为这对确定该疾病未来的防控非常有帮助。
