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哥伦比亚耐多药结核病,2013-2018 年:病例对照研究。

Tuberculosis multirresistente en Colombia, 2013-2018: estudio de casos y controles.

机构信息

Grupo Micobacterias, RED TB COLOMBIA, Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, D. C., Colombia.

Equipo Banco de Proyectos, RED TB COLOMBIA, Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, D. C., Colombia.

出版信息

Biomedica. 2023 Dec 1;43(4):447-456. doi: 10.7705/biomedica.6842.

Abstract

INTRODUCTION

Multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) is difficult to control, has high morbidity and mortality, and demands priority public health intervention. In Colombia, MDR/RR-TB has been becoming more widespread annually. Before the COVID-19 pandemic, over an 8-year period, the number of cases of multidrug-resistant tuberculosis in Colombia was close to a thousand cases. Timely identification of the different risk factors for MDR/RR-TB will contribute fundamentally to the systematic management.

OBJECTIVE

To determine which risk factors were associated with the presentation of MDR in Colombia between 2013 and 2018.

MATERIALS AND METHODS

A retrospective case-control study was carried out, for which the data from the routine surveillance of MDR/events in the country were used.

RESULTS

The cases of multidrug-resistant tuberculosis were mainly in young people, Afrodescendants, and males. Of the clinical conditions, comorbidities such as malnutrition, diabetes, and HIV, presence of at least one factor, such as drug dependence, taking immunosuppressive medications, belonging to the black race, afro, and living in an area of high disease burden were risk factors.

CONCLUSION

In addition to the diagnosis and timely provision of MDR-TB treatment, it is necessary that public health programs at the local level pay special attention to patients with the identified risk factors.

摘要

简介

耐多药/利福平耐药结核病(MDR/RR-TB)难以控制,发病率和死亡率高,需要优先进行公共卫生干预。在哥伦比亚,MDR/RR-TB 每年都在蔓延。在 COVID-19 大流行之前的 8 年期间,哥伦比亚耐多药结核病的病例数接近千例。及时确定 MDR/RR-TB 的不同危险因素将对系统管理做出根本性贡献。

目的

确定 2013 年至 2018 年间哪些危险因素与哥伦比亚出现 MDR 有关。

材料和方法

进行了一项回顾性病例对照研究,使用了该国常规监测 MDR 事件的数据。

结果

耐多药结核病病例主要发生在年轻人、非裔哥伦比亚人和男性中。在临床情况下,营养不良、糖尿病和 HIV 等合并症,以及存在药物依赖、服用免疫抑制药物、属于黑人、非裔以及生活在疾病负担高的地区等至少一个因素是危险因素。

结论

除了及时诊断和提供 MDR-TB 治疗外,地方一级的公共卫生方案还需要特别关注已确定的危险因素患者。

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