重新治疗结核病是乌干达东部农村艾滋病毒感染者多药耐药结核病的危险因素:一项嵌套病例控制研究
Godfrey Opolot1, Peter Olupot-Olupot1, Samuel Okware2
1Department of Community and Public Health, Busitema University, Uganda.
概括
重新治疗结核病 (TB) 在乌干达农村的艾滋病毒感染者 (PWH) 中显著增加了多药耐药结核病 (MDR-TB) 的风险. 这凸显了需要加强对先前结核病治疗的PWH的监测和支持.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 患有人类免疫缺陷病毒 (PWH) 的人面临患多药耐药结核病 (MDR-TB) 的风险更高.
- 了解PWH中MDR-TB的风险因素对于有针对性的干预至关重要,特别是在高负担地区.
研究的目的:
- 确定与乌干达东部农村PWH中MDR-TB相关的风险因素.
- 为预防和管理MDR-TB在这个脆弱人群中的公共卫生策略提供信息.
主要方法:
- 在乌干达东部农村地区进行了一项嵌套病例控制研究,审查了2017年1月至2024年5月的结核病记录.
- 病例是具有MDR-TB的PWH,对照组是没有MDR-TB的PWH (1:3比).
- 多变量二元逻辑回归分析了与MDR-TB.TB独立相关的因素.
主要成果:
- 重新治疗结核病在PWH中与MDR-TB有很强的关联 (调整后的几率比率[aOR]6.97;95% CI 2.65-19.46).
- 诸如男性性别,临床诊断的肺结核或肺外结核,以及最近开始抗逆转录病毒治疗等因素,与MDR-TB无关紧要.
结论:
- 重新治疗结核病是乌干达东部农村的PWH中MDR-TB的重要危险因素.
- 强化药物耐药性监测和坚持支持对于有结核病治疗史的PWH至关重要.
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