埃及 2021 年疑似结核病患者中利福平耐药结核病的流行情况：一项基于国家卫生机构的调查。
Prevalence of Rifampicin resistance tuberculosis among presumptive tuberculosis patients in Egypt-2021: a national health facility-based survey.
机构信息
Chest Diseases Department, Ministry of Health and Population, Cairo, Egypt.
Community, Environmental and Occupational medicine department, Faculty of Medicine-Ain, Shams University, Cairo, Egypt.
出版信息
BMC Infect Dis. 2024 Feb 15;24(1):210. doi: 10.1186/s12879-023-08807-7.
BACKGROUND
The magnitude of MDR-TB cases was noticeable in Egypt. However, the last national survey was 11-years ago. The current survey was conducted to determine the prevalence of rifampicin resistance among sputum smear-positive pulmonary tuberculosis patients in Egypt.
METHODS
A national health facility-based cross-sectional study was conducted in 14 randomly selected governorates in Egypt between August 2020 and September 2021. All presumptive TB cases, either new or previously treated according to WHO definitions, with no gender, age, or nationality limitations, and provided informed consent were included in the study. Each patient completed a case report form (CRF). The CRF included socio-demographic and clinical data. Sputum samples were collected according to standard techniques and cultured on Lowenstein-Jensen (L-J) medium. Gene X-pert test was carried out first on the samples for simultaneous identification of MTB and rifampicin resistance. The prevalence of RR was calculated using crude, cluster, and weighted methods. Factors associated with RR were analyzed by bivariate and multivariate techniques.
RESULTS
Among the total 849 presumptive TB patients enrolled in the study, 710 (83.6%) patients were subjected to Gene X-pert testing (MTB/RIF). The crude prevalence of RR was 3.32% (95% CI: 1.89-4.76%) among the new cases and 9.46% (95% CI: 2.63-16.29%) among the retreated cases with an overall estimate of 3.99%; (95% CI: 2.51-5.47%). By cluster analysis the overall prevalence of RR was 5.01% (95% CI: 2.90-7.13). Factors associated with the prevalence of RR were co-morbidity with bronchial asthma, drug abuse and history of contact with a family member with TB.
CONCLUSION
The prevalence of RR among either new or retreated cases TB patients was lower than the previous Egyptian rates in 2010-2012. The strongest predictor associated with RR was comorbidity with bronchial asthma.
背景
在埃及，耐多药结核病（MDR-TB）病例的严重程度相当显著。然而，上一次全国范围的调查已经是 11 年前的事了。本次调查旨在确定埃及痰涂片阳性肺结核患者中利福平耐药的流行率。
方法
2020 年 8 月至 2021 年 9 月，在埃及 14 个随机选定的省份进行了一项基于卫生机构的全国性横断面研究。所有按照世界卫生组织（WHO）定义为新发病例或既往治疗病例、无性别、年龄或国籍限制且已获得知情同意的疑似结核病患者均纳入本研究。每位患者填写病例报告表（CRF）。CRF 包括社会人口学和临床数据。按照标准技术采集痰标本并在 Lowenstein-Jensen（L-J）培养基上培养。首先对样本进行 Gene X-pert 检测，以同时鉴定结核分枝杆菌和利福平耐药性。采用粗率、聚类和加权方法计算 RR 流行率。采用单变量和多变量技术分析与 RR 相关的因素。
结果
在纳入本研究的 849 例疑似结核病患者中，有 710 例（83.6%）患者接受了 Gene X-pert 检测（MTB/RIF）。新发病例的 RR 粗率为 3.32%（95%CI：1.89-4.76%），复治病例为 9.46%（95%CI：2.63-16.29%），总体估计值为 3.99%（95%CI：2.51-5.47%）。通过聚类分析，RR 的总体流行率为 5.01%（95%CI：2.90-7.13%）。与 RR 流行率相关的因素包括合并支气管哮喘、药物滥用和与结核病家庭成员接触的病史。
结论
与 2010-2012 年埃及的比率相比，新发病例和复治病例的 RR 流行率较低。与 RR 相关性最强的预测因素是合并支气管哮喘。
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