Viral Shah, M Yogesh, Deep R Kothari, Rohankumar B Gandhi, Jay J Nagda
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Multinomial logistic regression analyzed risk factors for 200 drug-sensitive and 150 drug-resistant TB cases compared to participants without active or past TB.</p><p><strong>Results: </strong>Key factors independently associated with higher adjusted odds ratios (aOR) of both TB types included low socioeconomic status (SES) (drug-sensitive TB: aOR 1.7, 95% CI 1.2-2.5; drug-resistant TB: aOR 2.2, 95% CI 1.3-3.7), crowding (>5 persons/room) (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 1.9, 95% CI 1.2-2.9), undernutrition (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 2.0, 95% CI 1.2-3.2), smoking (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.3; drug-resistant TB: aOR 1.7, 95% CI 1.1-2.7), and indoor air pollution (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.2; drug-resistant TB: aOR 1.8, 95% CI 1.2-2.8).</p><p><strong>Conclusion: </strong>Marked social determinants and clinical risks drive heightened susceptibility for both TB types in India, while prior inadequate treatment and nosocomial exposures selectively enable additional drug resistance. Holistic prevention policies jointly targeting transmission, vulnerability, and curative factors are imperative.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11504741/pdf/","citationCount":"0","resultStr":"{\"title\":\"Audit of risk factors of drug-sensitive, drug-resistant tuberculosis disease, a case-control study of patients registered under NTEP, Gujarat.\",\"authors\":\"Viral Shah, M Yogesh, Deep R Kothari, Rohankumar B Gandhi, Jay J Nagda\",\"doi\":\"10.4103/jfmpc.jfmpc_1967_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Characterizing risk factors for drug-resistant tuberculosis (TB) is critical to guide targeted interventions in high-burden settings like India. We aimed to identify socioeconomic, lifestyle, and clinical factors associated with drug-sensitive and drug-resistant TB acquisition.</p><p><strong>Materials and methods: </strong>A comparative cross-sectional study recruited 350 bacteriologically confirmed TB patients registered under the National Tuberculosis Elimination Program (NTEP) in Gujarat, India, and 300 matched participants without active/past TB. Multinomial logistic regression analyzed risk factors for 200 drug-sensitive and 150 drug-resistant TB cases compared to participants without active or past TB.</p><p><strong>Results: </strong>Key factors independently associated with higher adjusted odds ratios (aOR) of both TB types included low socioeconomic status (SES) (drug-sensitive TB: aOR 1.7, 95% CI 1.2-2.5; drug-resistant TB: aOR 2.2, 95% CI 1.3-3.7), crowding (>5 persons/room) (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 1.9, 95% CI 1.2-2.9), undernutrition (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 2.0, 95% CI 1.2-3.2), smoking (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.3; drug-resistant TB: aOR 1.7, 95% CI 1.1-2.7), and indoor air pollution (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.2; drug-resistant TB: aOR 1.8, 95% CI 1.2-2.8).</p><p><strong>Conclusion: </strong>Marked social determinants and clinical risks drive heightened susceptibility for both TB types in India, while prior inadequate treatment and nosocomial exposures selectively enable additional drug resistance. 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引用次数: 0
摘要
背景：确定耐药性结核病（TB）的风险因素对于指导印度等高负担地区的针对性干预措施至关重要。我们旨在确定与获得药物敏感性和耐药性结核病相关的社会经济、生活方式和临床因素：一项横断面比较研究招募了 350 名根据印度古吉拉特邦国家结核病消除计划（NTEP）登记的细菌学确诊结核病患者，以及 300 名无活动性/既往结核病史的匹配参与者。与没有活动性或既往结核病史的参与者相比，多项式逻辑回归分析了 200 例药物敏感性结核病和 150 例耐药性结核病的风险因素：结果：与两种肺结核类型的调整赔率（aOR）较高独立相关的主要因素包括：社会经济地位低（SES）（药物敏感型肺结核：aOR 1.7，95% CI 1.2-2.5；耐药型肺结核：aOR 2.2，95% CI 1.3-3.7）、拥挤（>5 人/间）（药物敏感型肺结核：aOR 1.6，95% CI 1.1-2.3；耐药型肺结核：aOR 1.9，95% CI 1.2-2.9）、营养不良（对药物敏感的肺结核：aOR 1.6，95% CI 1.1-2.3；耐药性肺结核：aOR 2.0，95% CI 1.2-3.2）、吸烟（对药物敏感的肺结核：aOR 1.5，95% CI 1.0-2.3；耐药性肺结核：aOR 2.0，95% CI 1.2-3.2）。3；耐药结核病：aOR 1.7，95% CI 1.1-2.7）和室内空气污染（对药物敏感的结核病：aOR 1.5，95% CI 1.0-2.2；耐药结核病：aOR 1.8，95% CI 1.2-2.8）：结论：在印度，明显的社会决定因素和临床风险导致对两种结核病类型的易感性增加，而先前的不适当治疗和院内暴露则有选择性地使耐药性增加。针对传播、易感性和治疗因素的综合预防政策势在必行。
Audit of risk factors of drug-sensitive, drug-resistant tuberculosis disease, a case-control study of patients registered under NTEP, Gujarat.
Background: Characterizing risk factors for drug-resistant tuberculosis (TB) is critical to guide targeted interventions in high-burden settings like India. We aimed to identify socioeconomic, lifestyle, and clinical factors associated with drug-sensitive and drug-resistant TB acquisition.
Materials and methods: A comparative cross-sectional study recruited 350 bacteriologically confirmed TB patients registered under the National Tuberculosis Elimination Program (NTEP) in Gujarat, India, and 300 matched participants without active/past TB. Multinomial logistic regression analyzed risk factors for 200 drug-sensitive and 150 drug-resistant TB cases compared to participants without active or past TB.
Results: Key factors independently associated with higher adjusted odds ratios (aOR) of both TB types included low socioeconomic status (SES) (drug-sensitive TB: aOR 1.7, 95% CI 1.2-2.5; drug-resistant TB: aOR 2.2, 95% CI 1.3-3.7), crowding (>5 persons/room) (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 1.9, 95% CI 1.2-2.9), undernutrition (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 2.0, 95% CI 1.2-3.2), smoking (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.3; drug-resistant TB: aOR 1.7, 95% CI 1.1-2.7), and indoor air pollution (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.2; drug-resistant TB: aOR 1.8, 95% CI 1.2-2.8).
Conclusion: Marked social determinants and clinical risks drive heightened susceptibility for both TB types in India, while prior inadequate treatment and nosocomial exposures selectively enable additional drug resistance. Holistic prevention policies jointly targeting transmission, vulnerability, and curative factors are imperative.
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