抗結核薬剤耐性およびボツワナの結核患者における匿名HIV監視,2002年
L J Nelson1, E A Talbot, M J Mwasekaga
1Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA. LBN9@CDC.GOV
Lancet (London, England)
|August 9, 2005
まとめ
ボツワナにおける結核薬剤耐性は1995年から2002年にかけて著しく増加し,高いHIV感染率と一致した. 薬剤耐性の増大と闘うために,緊急の結核管理介入が必要である.
科学分野:
- 公衆衛生は公衆衛生である.
- 感染症 感染症は感染症です.
- エピデミオロジー エピデミオロジー
背景:
- ボツワナは1989年以来,結核 (TB) の発生率が3倍に増加した.
- 1990年代の以前の調査は,抗結核薬剤耐性の低い割合を示していた.
研究 の 目的:
- 1995年から2002年までのボツワナにおける結核薬剤耐性およびHIV感染率の動向を評価する.
- ボツワナの結核疫学におけるHIVの影響を決定する.
主な方法:
- 2002年に全国的な調査が行われ,結核患者の唾液サンプルが収集されました.
- 匿名で迅速なHIV検査 (Oraquick) を参加した患者さんに実施した.
- 薬剤耐性パターンは,新規および以前に治療された結核の症例について分析されました.
主要な成果:
- 結核患者のHIV感染率は高く,60% (2200例のうち1457例がスプレー陽性で,219例が再発) がHIVに感染していた.
- 新しい患者における抗結核薬剤耐性は,1995年の3.7%から2002年の10.4%に大幅に増加した (p<0.0001).
結論:
- ボツワナでは,薬剤耐性結核の有意な増加が報告されています.
- 高いHIV感染率は,結核の流行の重要な要因である.
- ボツワナでは,さらなる薬剤耐性を抑制するために,緊急かつ効果的な結核管理の介入が不可欠です.
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