在乌兹别克斯坦卡拉卡尔帕克斯坦的第二线耐药结核病和相关风险因素
S Moe1, I Azamat1, S Allamuratova1
1Médecins Sans Frontières (MSF), Nukus, Uzbekistan.
IJTLD open
|September 20, 2024
概括
耐药结核病 (DR-TB) 是一个重大威胁. 乌兹别克斯坦的研究表明,对贝达基林和线索利德等关键药物的耐药性高,需要进行基线测试才能有效治疗.
科学领域:
- 结核病研究 结核病研究
- 药物耐药性的流行病学
- 公共卫生 公共卫生
背景情况:
- 耐药结核病 (DR-TB) 构成了全球重大卫生挑战.
- 乌兹别克斯坦面临着相当大的DR-TB负担,对抗药对新药耐药性的数据有限.
- 诺基诺,贝达基林和线索利德对于治疗耐利芬辛结核病至关重要.
研究的目的:
- 确定乌兹别克斯坦的二线耐药结核病 (SLDR-TB) 的流行率.
- 确定与SLDR-TB相关的人口和临床风险因素.
- 为该地区DR-TB的治疗策略提供信息.
主要方法:
- 对2019-2023年的计划数据进行回顾性分析.
- 用于SLDR-TB评估的表型药物敏感性测试 (pDST).
- 多变量逻辑回归 (艾伦-凯迪方法) 用于风险因素分析.
主要成果:
- 分析了2,405名结核病患者;24%的人患有SLDR-TB.
- 耐药性的发生率:贝达基林 (3.1%),线化物 (0.8%),诺基诺 (莫西素15%,勒沃素13%),阿米卡 (12%).
- 风险因素包括先前的耐药性,克洛法齐明暴露,再治疗,结核病接触和糖尿病.
结论:
- 较高的SLDR-TB患病率强调了基线pDST在抗利芬辛结核病 (RR-TB) 治疗中的需要.
- 鉴定的风险因素可以指导风险患者的早期检测和临床管理.
- 这些发现支持优化乌兹别克斯坦的DR-TB治疗方案.
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