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加强里约热内卢抗药性结核病流行病监测:一个多维分析

Marcela Bhering¹, Afrânio Kritski²

¹Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, RJ, Brasil.

Revista da Sociedade Brasileira de Medicina Tropical

|July 31, 2024

概括

里约热内卢对多药耐药结核病 (MDR-TB) 的流行病学监测显示了日益增长的趋势和不利的结果. 改善诊断和治疗对于对抗MDR-TB和广泛耐药结核病 (XDR-TB) 至关重要.

科学领域:

公共卫生公共卫生
传染性疾病传染性疾病
流行病学流行病学

背景情况:

多药耐药结核病 (MDR-TB) 监测在里约热内卢州 (RJ) 是至关重要的.
之前的研究强调了对MDR-TB诊断和治疗结果的挑战.
多抗药性结核病例的增加趋势需要加强监测策略.

研究的目的:

加强对里约热内卢州MDR-TB的流行病学监测的重要性.
分析患者的特征,治疗结果和耐药性模式.
确定在MDR-TB诊断和治疗级联中需要改进的关键领域.

主要方法:

这是一项两阶段研究,结合了定量 (频率,回归分析) 和定性 (内容分析) 方法.
分析来自电子系统的二次数据和来自半结构面试的初级数据.
综述了从2018年至2022年之前发表的七篇文章.

主要成果:

分析了2,269例MDR-TB病例,其中18.6%被归类为广泛耐药结核病 (XDR-TB).
44.3%的MDR-TB病例有不良结果;29.3%的XDR-TB患者之前没有接受过MDR-TB治疗.
从2000年到2018年,MDR-TB病例显著增加 (AAPC = 9.4),报告不足率为25.4%.
定性数据显示高初级耐药性 (64.5%) 和延迟诊断.

结论:

在RJ的MDR-TB的诊断和治疗级联需要显著的改进.
通过分子测试进行早期诊断和及时启动治疗至关重要.
建议加强社会保护,联系人追踪,综合监控和系统互操作性.

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