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埃塞俄比亚北沃洛受战争影响地区疑似结核病患者中结核病的患病率及相关因素

Prevalence and factors associated with TB among presumptive TB patients in war-affected areas of North Wollo, Ethiopia.

作者信息

Asmare Zelalem, Assefa Abebe, Belay Amanuel, Mulie Ayehu, Aschil Dawit, Gashaw Yalewayker

机构信息

Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia.

Department of Medical Laboratory Science, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.

出版信息

JAC Antimicrob Resist. 2025 Jan 2;7(1):dlae206. doi: 10.1093/jacamr/dlae206. eCollection 2025 Feb.

Abstract

BACKGROUND

TB is a leading infectious disease globally, with war and displacement significantly increasing its burden. In Ethiopia, ongoing conflict and displacement have worsened health conditions, yet data on TB prevalence and resistance remain scarce. This study aimed to determine the prevalence of TB, rifampicin-resistant TB (RR-TB), and associated factors among presumptive TB patients in hospitals during the ongoing crisis.

METHODS

A cross-sectional study was conducted with 273 presumptive TB participants, recruited via convenience sampling. Data on socio-demographic and behavioural factors were collected through interviews using a pre-tested structured questionnaire. Sputum samples were examined using the Xpert MTB/RIF molecular assay. Binary logistic regression was used to analyse the association between independent variables and TB. Variables with a value  ≤0.25 in the univariate analysis were included in the multivariable regression to identify independent predictors, with a value ≤0.05 considered statistically significant.

RESULTS

Among the 273 study participants, 47 were confirmed to have , resulting in a prevalence of 17.2%. Of the 47 patients diagnosed with , 17 (36.2%) were found to have rifampicin-resistant strains. Previous contact with displaced persons [adjusted odds ratio (AOR): 4.237; 95% CI: 1.67-10.762; value: 0.002), contact with TB-infected individuals (AOR: 5.644; 95% CI: 2.46-12.96; value: <0.01) and being HIV positive (AOR: 3.074; 95% CI: 1.26-7.50; value: 0.014) were the significant predictors for TB.

CONCLUSIONS

Our study revealed a troubling prevalence of RR-TB, underscoring the adverse effects of war and displacement on healthcare services. Significant associations with predictors like HIV infection and close contact with TB-infected individuals necessitate targeted interventions.

摘要

背景

结核病是全球主要的传染病,战争和流离失所显著增加了其负担。在埃塞俄比亚,持续的冲突和流离失所使健康状况恶化,但关于结核病患病率和耐药性的数据仍然匮乏。本研究旨在确定当前危机期间医院中疑似结核病患者的结核病、耐利福平结核病(RR-TB)患病率及相关因素。

方法

采用便利抽样法对273名疑似结核病参与者进行了横断面研究。通过使用预先测试的结构化问卷进行访谈,收集社会人口学和行为因素的数据。痰标本采用Xpert MTB/RIF分子检测法进行检测。采用二元逻辑回归分析自变量与结核病之间的关联。单变量分析中P值≤0.25的变量纳入多变量回归以确定独立预测因素,P值≤0.05被认为具有统计学意义。

结果

在273名研究参与者中,47人被确诊患有结核病,患病率为17.2%。在47名被诊断为结核病的患者中,17人(36.2%)被发现患有耐利福平菌株。既往与流离失所者接触[调整优势比(AOR):4.237;95%置信区间:1.67 - 10.762;P值:0.002]、与结核病感染者接触(AOR:5.644;95%置信区间:2.46 - 12.96;P值:<0.01)以及HIV阳性(AOR:3.074;95%置信区间:1.26 - 7.50;P值:0.014)是结核病的重要预测因素。

结论

我们的研究揭示了耐利福平结核病令人担忧的患病率,凸显了战争和流离失所对医疗服务的不利影响。与HIV感染和与结核病感染者密切接触等预测因素的显著关联需要有针对性的干预措施。

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