Tuberculosis multirresistente en Colombia, 2013-2018: estudio de casos y controles

Gloria Mercedes Puerto, Claudia Marcela Castro, Vivian Vanesa Rubio, Santiago Fadul, Fernando Montes
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Abstract

Introduction: Multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) is difficult to control, has high morbidity and mortality, and demands priority public health intervention. In Colombia, MDR/RR-TB has been becoming more widespread annually. Before the COVID-19 pandemic, over an 8-year period, the number of cases of multidrug-resistant tuberculosis in Colombia was close to a thousand cases. Timely identification of the different risk factors for MDR/RR-TB will contribute fundamentally to the systematic management.

Objective: To determine which risk factors were associated with the presentation of MDR in Colombia between 2013 and 2018.

Materials and methods: A retrospective case-control study was carried out, for which the data from the routine surveillance of MDR/events in the country were used.

Results: The cases of multidrug-resistant tuberculosis were mainly in young people, Afrodescendants, and males. Of the clinical conditions, comorbidities such as malnutrition, diabetes, and HIV, presence of at least one factor, such as drug dependence, taking immunosuppressive medications, belonging to the black race, afro, and living in an area of high disease burden were risk factors.

Conclusion: In addition to the diagnosis and timely provision of MDR-TB treatment, it is necessary that public health programs at the local level pay special attention to patients with the identified risk factors.

2013-2018 年哥伦比亚的耐多药结核病:病例对照研究
导言:耐多药/耐利福平结核病(MDR/RR-TB)难以控制,发病率和死亡率高,需要优先采取公共卫生干预措施。在哥伦比亚,耐药结核病/耐利福平结核病的发病率逐年上升。在 COVID-19 大流行之前的 8 年间,哥伦比亚的耐多药结核病病例接近一千例。及时发现耐多药/耐药结核病的不同风险因素将从根本上促进系统管理:确定哪些风险因素与2013年至2018年间哥伦比亚出现MDR相关:开展了一项回顾性病例对照研究,研究使用了该国MDR/事件的常规监测数据:耐多药肺结核病例主要是年轻人、非洲裔和男性。在临床病症中,营养不良、糖尿病、艾滋病等合并症,至少存在一种因素,如药物依赖、服用免疫抑制药物、属于黑人、非洲裔、生活在疾病负担重的地区等,都是风险因素:除了诊断和及时提供 MDR-TB 治疗外,地方一级的公共卫生计划有必要特别关注具有已确定风险因素的患者。
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