埃塞俄比亚迪拉大学转诊医院结核病患者中耐药结核分枝杆菌的患病率及其相关因素

Prevalence of drug-resistant Mycobacterium tuberculosis and its associated factors among tuberculosis patients attending Dilla university referral hospital, Ethiopia.

作者信息

Hatiya Melat, Merid Yared, Mola Addis, Belayneh Fanuel, Ali Musa Mohammed

机构信息

Hawassa Health Science College, Hawassa, Ethiopia.

College of Medicine and Health Sciences, School of Medical Laboratory Science, Hawassa University, Hawassa, Ethiopia.

出版信息

BMC Infect Dis. 2025 Jun 6;25(1):797. doi: 10.1186/s12879-025-11191-z.

Abstract

BACKGROUND

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB) and is the second leading cause of death from contagious diseases worldwide. Ethiopia is among the 30 countries with the highest burden of TB and TB/HIV co-infection. The emergence and spread of drug-resistant TB present significant challenges to TB care and control efforts, particularly multi-drug-resistant TB, which poses a serious public health issue in low-income countries such as Ethiopia. This study aimed to determine the prevalence of drug-resistant TB and its associated factors among TB patients in Dilla University Referral Hospital (DURH).

METHOD

A prospective cross-sectional study was conducted from March-2024 to May-2024 among 216 pulmonary TB patients attending DURH. Gene Xpert MTB/RIF Ultra and Xpert MTB/XDR assay was used to assess the pattern of drug resistance in TB. The Xpert MTB/RIF Ultra assay was used to detect rifampicin resistance, while the Xpert MTB/XDR assay was employed to identify isoniazid resistance and resistance to second-line anti-TB drugs when rifampicin resistance was detected. Data were analyzed by using the Statistical Package for Social Sciences (SPSS) version 25.

RESULT

In this study, out of 216 confirmed MTB cases, 5 (2.3%) were identified as drug-resistant TB (DR-TB), with mono-resistance to rifampicin and isoniazid at 1.4% and 0.9%, respectively. The statistical analysis revealed a significant difference in DR-TB prevalence between those with and without a history of anti-TB treatment (p = 0.001). Notably, isoniazid mono-resistant TB was more prevalent among individuals with diabetes mellitus and those with a history of previous treatment, showing p-values of 0.018 and 0.015, respectively.

CONCLUSION

Among the 216 confirmed TB cases, 5 cases of DR-TB were identified, accounting for 2.3%. DR-TB was more prevalent in patients with a history of anti-TB treatment, highlighting the urgent need for enhanced early detection and improved treatment monitoring. Additionally, isoniazid mono-resistant TB was notably prevalent in individuals with diabetes mellitus and prior treatment history, with p-values of 0.018 and 0.015, respectively. Targeted interventions for these high-risk groups are essential to address drug resistance in TB, enabling us to effectively tackle the emergence of drug-resistant TB at both local and national levels.

摘要

背景

结核病(TB)是由结核分枝杆菌(MTB)引起的一种传染病,是全球传染性疾病致死的第二大原因。埃塞俄比亚是结核病和结核病/艾滋病毒合并感染负担最高的30个国家之一。耐多药结核病的出现和传播给结核病防治工作带来了重大挑战,尤其是多重耐药结核病,这在埃塞俄比亚等低收入国家构成了严重的公共卫生问题。本研究旨在确定迪拉大学转诊医院(DURH)结核病患者中耐多药结核病的患病率及其相关因素。

方法

于2024年3月至2024年5月对216名在DURH就诊的肺结核患者进行了一项前瞻性横断面研究。采用Gene Xpert MTB/RIF Ultra和Xpert MTB/XDR检测方法评估结核病的耐药模式。Xpert MTB/RIF Ultra检测方法用于检测利福平耐药性,而Xpert MTB/XDR检测方法用于在检测到利福平耐药时鉴定异烟肼耐药性和对二线抗结核药物的耐药性。使用社会科学统计软件包(SPSS)25版对数据进行分析。

结果

在本研究中,216例确诊的MTB病例中,有5例(2.3%)被确定为耐多药结核病(DR-TB),对利福平和异烟肼的单耐药率分别为1.4%和0.9%。统计分析显示,有抗结核治疗史和无抗结核治疗史的患者中DR-TB患病率存在显著差异(p = 0.001)。值得注意的是,异烟肼单耐药结核病在糖尿病患者和有既往治疗史的患者中更为普遍,p值分别为0.018和0.015。

结论

在216例确诊的结核病病例中,发现5例DR-TB病例,占2.3%。DR-TB在有抗结核治疗史的患者中更为普遍,突出了加强早期检测和改善治疗监测的迫切需要。此外,异烟肼单耐药结核病在糖尿病患者和有既往治疗史的个体中显著普遍,p值分别为0.018和0.015。针对这些高危人群的有针对性干预对于应对结核病耐药性至关重要,使我们能够在地方和国家层面有效应对耐多药结核病的出现。

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