Birhanu Molla Yigzaw, Bekele Getamesay Molla, Jemberie Selamawit Shita
Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Department of Gynecology and Obstetrics, School of Medicine, Debre Markos University, Debre Markos, Ethiopia.
Front Med (Lausanne). 2024 Jun 7;11:1319845. doi: 10.3389/fmed.2024.1319845. eCollection 2024.
Tuberculosis is a contagious bacterial disease caused by . The emergence and spread of drug-resistant strains of in both developing and developed countries has made diagnosis, treatment, and control of tuberculosis more difficult. The PCR assay, which is a fast and sensitive technique and an alternative method for detecting multidrug-resistant tuberculosis, is used to determine rifampicin (RIF) resistance. There is no single figure in Ethiopia that represents rifampicin-resistant tuberculosis and that is why this study was conducted to overcome the inconsistency of the results of the previous studies.
Studies were researched from five major electronic databases. Studies which were cross-sectional in design, published, and written in English were included. The data were extracted using Microsoft Excel, and the data were managed and analyzed using Stata™ Version 17.0 statistical software. The Forest plot was used to check the presence of heterogeneity. The publication bias, meta-regression, and subgroup analysis were used to find out the source of heterogeneity. A random effect analysis model was used to pool the prevalence of RR TB from primary studies, and associated factors of RR among TB patients were identified using Meta regression. The presence of association was reported using OR with 95% CI.
The overall pooled prevalence of tuberculosis was 14.9% (95% CI: 13.34, 16.46), of these approximately 7.48% (95% CI: 6.30, 8.66) showed rifampicin-resistant tuberculosis in Ethiopia. Among the computed variables, 2.05% living with HIV1.39 (95%CI: 1.13, 1.72) and having a history of TB treatment (95%CI: 1.34, 3.15) were identified as significant factors associated with RR TB in Ethiopia.
Drug-resistant TB is one of the prevalent emerging infectious diseases among TB patients, which affects approximately one out of every thirteen TB patients. Having TB-HIV coinfection and a history of prior TB treatment were identified as significant factors associated with RR TB. To prevent and control RR TB, patients should complete their follow-up course; the health professionals should educate the actions taken by the patients when they experience drug toxicity and side effects; and the Minister of Health should initiate telemedicine and recruit tracers to overcome TB patients' default and have good drug adherence and retention after initiation of the treatment.
结核病是一种由……引起的传染性细菌性疾病。耐药菌株在发展中国家和发达国家的出现与传播，使得结核病的诊断、治疗和控制变得更加困难。聚合酶链反应（PCR）检测是一种快速且灵敏的技术，也是检测耐多药结核病的一种替代方法，用于确定利福平（RIF）耐药情况。在埃塞俄比亚，没有一个单一的数据能代表利福平耐药结核病情况，这就是开展本研究以克服以往研究结果不一致问题的原因。
从五个主要电子数据库检索研究。纳入设计为横断面研究、已发表且用英文撰写的研究。使用Microsoft Excel提取数据，并使用Stata™ 17.0统计软件进行数据管理和分析。森林图用于检查异质性的存在。采用发表偏倚、Meta回归和亚组分析来找出异质性来源。采用随机效应分析模型汇总来自原始研究的耐利福平结核病患病率，并使用Meta回归确定结核病患者中耐利福平的相关因素。使用比值比（OR）及95%置信区间（CI）报告关联的存在情况。
结核病的总体合并患病率为14.9%（95%CI：13.34，16.46），其中在埃塞俄比亚，约7.48%（95%CI：6.30，8.66）表现为利福平耐药结核病。在计算的变量中，感染HIV（95%CI：1.13，1.72）以及有结核病治疗史（95%CI：1.34，3.15）被确定为埃塞俄比亚耐利福平结核病的显著相关因素。
耐多药结核病是结核病患者中普遍出现的新发传染病之一，每13名结核病患者中约有1人受其影响。结核病与HIV合并感染以及既往有结核病治疗史被确定为耐利福平结核病的显著相关因素。为预防和控制耐利福平结核病，患者应完成后续疗程；卫生专业人员应就患者出现药物毒性和副作用时应采取的措施进行教育；卫生部应启动远程医疗并招募追踪人员，以克服结核病患者的治疗中断情况，并在治疗开始后实现良好的药物依从性和留存率。
