Department of Public Health, Texila American University, Lusaka, Zambia.
BMC Infect Dis. 2024 Apr 1;24(1):364. doi: 10.1186/s12879-024-09238-8.
The emergence of Drug Resistant Tuberculosis (DR-TB) is one of the main public health and economic problems facing the world today. DR-TB affects mostly those in economically productive years and prevents them from being part of the workforce needed for economic growth. The aim of this study was to determine the Clinical Profile and Outcomes of DR-TB in Central Province of Zambia.
This was a retrospective cross sectional study that involved a review of records of patients with confirmed DR-TB who were managed at Kabwe Central Hospital's Multi-Drug Resistant TB (MDR-TB) Ward from the year 2017 to 2021. 183 patients were managed during this period and all were recruited in the study. Data was collected from DR-TB registers and patient files and then entered in SPSS version 22 where all statistical analyses were performed.
The study revealed that the prevalence of DR-TB among registered TB patients in Central Province was 1.4%. Majority of those affected were adults between the ages of 26 and 45 years (63.9%). The study also found that more than half of the patients were from Kabwe District (60.7%). Other districts with significant number of cases included Kapiri Mposhi 19 (10.4%), Chibombo 12 (6.6%), Chisamba 10 (5.5%), Mumbwa 7 (3.8%) and Mkushi 7 (3.8%). Furthermore, the analysis established that most of the patients had RR-TB (89.6%). 9.3% had MDR-TB, 0.5% had IR-TB and 0.5% had XDR-TB. RR-TB was present in 93.8% of new cases and 88.9% of relapse cases. MDR-TB was present in 6.2% of new cases and 10% of relapse cases. With regard to outcomes of DR-TB, the investigation revealed that 16.9% of the patients had been declared cured, 45.9% had completed treatment, 6% were lost to follow up and 21.3% had died. Risk factors for mortality on multivariate analysis included age 36-45 years (adjusted odds ratio [aOR] 0.253, 95% CI [0.70-0.908] p = 0.035) and male gender (aOR 0.261, 95% CI [0.107-0.638] p = 0.003).
The research has shown beyond doubt that the burden of DR-TB in Central Province is high. The study recommends putting measures in place that will help improve surveillance, early detection, early initiation of treatment and proper follow up of patients.
耐药结核病 (DR-TB) 的出现是当今世界面临的主要公共卫生和经济问题之一。DR-TB 主要影响那些处于经济生产年龄段的人群，并使他们无法成为经济增长所需劳动力的一部分。本研究旨在确定赞比亚中部省 DR-TB 的临床特征和结局。
这是一项回顾性横断面研究，涉及对 2017 年至 2021 年期间在卡布韦中央医院耐多药结核病 (MDR-TB) 病房管理的确诊 DR-TB 患者的记录进行审查。在此期间共管理了 183 名患者，所有患者均纳入研究。数据从 DR-TB 登记册和患者档案中收集，并输入 SPSS 版本 22 进行所有统计分析。
该研究表明，中部省登记结核病患者中 DR-TB 的患病率为 1.4%。受影响的大多数人是 26 至 45 岁的成年人（63.9%）。研究还发现，超过一半的患者来自卡布韦区（60.7%）。其他病例较多的地区包括 Kapiri Mposhi 19 例（10.4%）、Chibombo 12 例（6.6%）、Chisamba 10 例（5.5%）、Mumbwa 7 例（3.8%）和 Mkushi 7 例（3.8%）。此外，分析还发现，大多数患者患有 RR-TB（89.6%）。9.3%的患者患有 MDR-TB，0.5%的患者患有 IR-TB，0.5%的患者患有 XDR-TB。RR-TB 存在于 93.8%的新发病例和 88.9%的复发病例中。MDR-TB 存在于 6.2%的新发病例和 10%的复发病例中。关于 DR-TB 的结局，调查显示，16.9%的患者已被宣布治愈，45.9%的患者已完成治疗，6%的患者失访，21.3%的患者死亡。多变量分析显示，死亡的危险因素包括 36-45 岁年龄组（调整后优势比[aOR]0.253，95%CI[0.70-0.908]p=0.035）和男性（aOR 0.261，95%CI[0.107-0.638]p=0.003）。
研究无可置疑地表明，中部省 DR-TB 的负担很高。研究建议采取措施，帮助改善监测、早期发现、早期开始治疗和适当随访患者。
