在莫罗贝省的耐药结核病,巴布亚新几内亚,2012-2021年
L Bumbu1, S Vaccher2, A Holmes2
1Angau Memorial Provincial Hospital, Morobe Provincial Health Authority, Papua New Guinea.
Public health action
|December 2, 2024
概括
在巴布亚新几内亚,多药耐药结核病的检测增加,但治疗成功率仍然很低. 加强诊断和分散护理对于打击摩罗贝省耐药结核病至关重要.
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:
- 巴布亚新几内亚面临着高负担的多药耐药或耐利素结核病 (MDR/RR-TB).
- 在人口最多的Morobe省,MDR/RR-TB的数据有限.
- 了解检测和治疗对于国家结核病控制工作至关重要.
研究的目的:
- 描述莫罗贝省MDR/RR-TB检测和治疗结果.
- 评估COVID-19对MDR/RR-TB病例通知的影响.
- 确定与不良治疗结果相关的因素.
主要方法:
- 追溯队列研究,利用从2012年至2021年的常规计划注册数据.
- 对160例细菌学确诊的MDR/RR-TB病例进行分析.
- 多变量回归用于比较有利和不利的治疗结果.
主要成果:
- 随着GeneXpert的引入,2016年后,MDR/RR-TB病例通知显著增加,在COVID-19相关下降之前,在2020年达到顶峰.
- 观察到高失踪率 (27.5%) 和死亡率 (8.1%).
- 不利的结果与男性性别和更长时间的含注射剂的治疗方案有关.
结论:
- 虽然MDR/RR-TB检测有所改善,但诊断能力仍需要提高,特别是在儿童,肺外病例和农村人口中.
- 低治疗成功率需要紧急干预,以防止耐药结核病的进一步出现.
- 在摩洛贝省,分散的诊断和改进的治疗策略是必不可少的.
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