Moga S, Abebe T, Bobosha K, Alemu A, Diriba G, Harrington K R V, Lyles R H, Blumberg H M, Kempker R R
Addis Ababa University (AAU), Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa, Ethiopia.
Ethiopian Public Health Institute (EPHI), Infectious Diseases Research Directorate, Addis Ababa, Ethiopia.
Public Health Action. 2025 Jun 4;15(2):76-81. doi: 10.5588/pha.25.0002. eCollection 2025 Jun.
Isoniazid-resistant, rifampicin-susceptible (Hr-TB) is the most common form of drug-resistant TB (DR-TB). We investigated the prevalence of and risk factors for Hr-TB in Ethiopia.
A cross-sectional study was conducted to determine the magnitude of Hr-TB, and to compare characteristics of persons with Hr-TB to those with multidrug-resistant TB (MDR-TB) and INH/RMP-susceptible TB identified during the National Drug Resistance Survey from 2017-2019.
Among 1927 isolates recovered from persons with pulmonary TB, the prevalence of Hr-TB was 4.1% (95% CI 3.2-5.1), whereas the prevalence of MDR-TB was 1.9%. (95% CI 1.3-2.6). Unlike MDR-TB, the occurrence of Hr-TB did not differ significantly between new and previously treated TB cases ( = 0.67). The prevalence of Hr-TB cases was high in the Amhara (8.0%, 95% CI 4.8-12.5) region and Addis Ababa (7.1%, 95% CI 3.4-13.0). The proportion of Hr-TB increased with age (OR 1.02, 95% CI 1.01-1.04; = 0.035). Compared to INH/RMP-susceptible TB, Hr-TB was more likely to harbor resistance to ethambutol, streptomycin and pyrazinamide ( < 0.0001).
Hr-TB is the most prevalent type of DR-TB in Ethiopia and varies among regional states. Given the lack of identifiable clinical factors associated with Hr-TB, we recommend screening all bacteriologically confirmed TB cases for INH resistance at baseline.
异烟肼耐药、利福平敏感的结核病（Hr-TB）是耐药结核病（DR-TB）最常见的形式。我们调查了埃塞俄比亚Hr-TB的患病率及危险因素。
开展了一项横断面研究，以确定Hr-TB的流行程度，并比较2017 - 2019年全国耐药性调查期间确定的Hr-TB患者与耐多药结核病（MDR-TB）患者以及异烟肼/利福平敏感结核病患者的特征。
在从肺结核患者中分离出的1927株菌株中，Hr-TB的患病率为4.1%（95%置信区间3.2 - 5.1），而MDR-TB的患病率为1.9%（95%置信区间1.3 - 2.6）。与MDR-TB不同，新发病例和既往治疗过的结核病例中Hr-TB的发生率差异无统计学意义（P = 0.67）。阿姆哈拉地区（8.0%，95%置信区间4.8 - 12.5）和亚的斯亚贝巴（7.1%，95%置信区间3.4 - 13.0）的Hr-TB病例患病率较高。Hr-TB的比例随年龄增加而升高（比值比1.02，95%置信区间1.01 - 1.04；P = 0.035）。与异烟肼/利福平敏感结核病相比，Hr-TB更易对乙胺丁醇、链霉素和吡嗪酰胺耐药（P < 0.0001）。
Hr-TB是埃塞俄比亚最常见的耐药结核病类型，且在各地区有所不同。鉴于缺乏与Hr-TB相关的可识别临床因素，我们建议在基线时对所有经细菌学确诊的结核病例进行异烟肼耐药筛查。
