Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe Campus, Hohoe, Ghana.
Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana.
PLoS One. 2023 Nov 29;18(11):e0294928. doi: 10.1371/journal.pone.0294928. eCollection 2023.
Multidrug-resistant Tuberculosis (MDR-TB) remains a global health concern. The disease results in a prolonged treatment and hence, poses a financial burden to affected individuals and their families. The Ghana National TB Control Programme (NTP) has made extensive efforts to control the menace, however, it remains a concern. This study, therefore, aimed to determine the predictors of multidrug-resistant TB in the Cape Coast Teaching Hospital of Ghana. An unmatched case-control study involving 37 cases and 111 controls was conducted using data of TB cases registered for treatment between January 2018 and December 2020 at the Cape Coast Teaching Hospital. Socio-demographic, individual level and social characteristics information were collected from respondents through telephone surveys, face-to-face interviews and review of records using a structured questionnaire built in the Kobo Collect Toolbox. The data was exported to Stata version 16.0 for analysis. Chi-square test and multiple logistic regression were used to determine the predictors of MDR-TB. Associations were considered statistically significant at a 95% confidence interval with a p-value of less than 0.05. The results revealed that the majority (25 [67.6%]) of MDR-TB cases and controls (76 [68.5%]) were aged 30 years and above with a median age of 36.5 (IQR: 28-50) years for all respondents, while 20 (54.1%) of MDR-TB cases and 33 (29.7%) of controls lived in households with one room residences for their families. The following predictors for MDR-TB were identified: BCG vaccination status (AOR = 0.17,95% CI:0.07-0.45), long distance to health facility (AOR = 4.11, 95% CI: 1.55-10.87), number of rooms in residence (AOR = 0.37,95% CI: 0.14-0.99) and first place of visit upon noticing TB symptom (AOR = 4.22,95% CI:1.31-13.64). Predictors of MDR-TB in the current study were multi-faceted. Measures to control MDR-TB should target socio-demographic, health-seeking behaviour and social-related concerns.
耐多药结核病（MDR-TB）仍然是一个全球卫生关注问题。这种疾病导致治疗时间延长，因此给患者及其家庭带来了经济负担。加纳国家结核病控制规划（NTP）已经做出了广泛的努力来控制这种威胁，但它仍然是一个问题。因此，本研究旨在确定加纳科特海岸教学医院耐多药结核病的预测因素。这是一项采用病例对照设计的研究，涉及 37 例病例和 111 例对照，使用了 2018 年 1 月至 2020 年 12 月期间在科特海岸教学医院登记治疗的结核病病例的数据。通过电话调查、面对面访谈和使用 Kobo 收集工具包中内置的结构化问卷对受访者进行了社会人口统计学、个人层面和社会特征信息的收集。数据被导出到 Stata 版本 16.0 进行分析。卡方检验和多因素逻辑回归用于确定 MDR-TB 的预测因素。关联在 95%置信区间内被认为具有统计学意义，p 值小于 0.05。结果表明，大多数（25[67.6%]）MDR-TB 病例和对照（76[68.5%]）年龄在 30 岁及以上，所有受访者的中位数年龄为 36.5（IQR：28-50）岁，而 20（54.1%）MDR-TB 病例和 33（29.7%）对照居住在一个房间的家庭。确定了以下 MDR-TB 的预测因素：卡介苗接种状况（AOR=0.17，95%CI：0.07-0.45）、到医疗机构的距离（AOR=4.11，95%CI：1.55-10.87）、居住的房间数量（AOR=0.37，95%CI：0.14-0.99）和首次发现结核病症状时的就诊地点（AOR=4.22，95%CI：1.31-13.64）。当前研究中 MDR-TB 的预测因素是多方面的。控制 MDR-TB 的措施应针对社会人口统计学、寻求医疗服务行为和社会相关问题。
