S Moga, T Abebe, K Bobosha, A Alemu, G Diriba, K R V Harrington, R H Lyles, H M Blumberg, R R Kempker
{"title":"埃塞俄比亚的异烟肼耐药结核病及其相关因素。","authors":"S Moga, T Abebe, K Bobosha, A Alemu, G Diriba, K R V Harrington, R H Lyles, H M Blumberg, R R Kempker","doi":"10.5588/pha.25.0002","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Isoniazid-resistant, rifampicin-susceptible <i>Mycobacterium tuberculosis</i> (Hr-TB) is the most common form of drug-resistant TB (DR-TB). We investigated the prevalence of and risk factors for Hr-TB in Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to determine the magnitude of Hr-TB, and to compare characteristics of persons with Hr-TB to those with multidrug-resistant TB (MDR-TB) and INH/RMP-susceptible TB identified during the National Drug Resistance Survey from 2017-2019.</p><p><strong>Results: </strong>Among 1927 <i>M. tuberculosis</i> isolates recovered from persons with pulmonary TB, the prevalence of Hr-TB was 4.1% (95% CI 3.2-5.1), whereas the prevalence of MDR-TB was 1.9%. (95% CI 1.3-2.6). Unlike MDR-TB, the occurrence of Hr-TB did not differ significantly between new and previously treated TB cases (<i>P</i> = 0.67). The prevalence of Hr-TB cases was high in the Amhara (8.0%, 95% CI 4.8-12.5) region and Addis Ababa (7.1%, 95% CI 3.4-13.0). The proportion of Hr-TB increased with age (OR 1.02, 95% CI 1.01-1.04; <i>P</i> = 0.035). Compared to INH/RMP-susceptible TB, Hr-TB was more likely to harbor resistance to ethambutol, streptomycin and pyrazinamide (<i>P</i> < 0.0001).</p><p><strong>Conclusions: </strong>Hr-TB is the most prevalent type of DR-TB in Ethiopia and varies among regional states. Given the lack of identifiable clinical factors associated with Hr-TB, we recommend screening all bacteriologically confirmed TB cases for INH resistance at baseline.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 2","pages":"76-81"},"PeriodicalIF":1.3000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143246/pdf/","citationCount":"0","resultStr":"{\"title\":\"Isoniazid-resistant TB and associated factors in Ethiopia.\",\"authors\":\"S Moga, T Abebe, K Bobosha, A Alemu, G Diriba, K R V Harrington, R H Lyles, H M Blumberg, R R Kempker\",\"doi\":\"10.5588/pha.25.0002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Isoniazid-resistant, rifampicin-susceptible <i>Mycobacterium tuberculosis</i> (Hr-TB) is the most common form of drug-resistant TB (DR-TB). We investigated the prevalence of and risk factors for Hr-TB in Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to determine the magnitude of Hr-TB, and to compare characteristics of persons with Hr-TB to those with multidrug-resistant TB (MDR-TB) and INH/RMP-susceptible TB identified during the National Drug Resistance Survey from 2017-2019.</p><p><strong>Results: </strong>Among 1927 <i>M. tuberculosis</i> isolates recovered from persons with pulmonary TB, the prevalence of Hr-TB was 4.1% (95% CI 3.2-5.1), whereas the prevalence of MDR-TB was 1.9%. (95% CI 1.3-2.6). Unlike MDR-TB, the occurrence of Hr-TB did not differ significantly between new and previously treated TB cases (<i>P</i> = 0.67). The prevalence of Hr-TB cases was high in the Amhara (8.0%, 95% CI 4.8-12.5) region and Addis Ababa (7.1%, 95% CI 3.4-13.0). The proportion of Hr-TB increased with age (OR 1.02, 95% CI 1.01-1.04; <i>P</i> = 0.035). Compared to INH/RMP-susceptible TB, Hr-TB was more likely to harbor resistance to ethambutol, streptomycin and pyrazinamide (<i>P</i> < 0.0001).</p><p><strong>Conclusions: </strong>Hr-TB is the most prevalent type of DR-TB in Ethiopia and varies among regional states. Given the lack of identifiable clinical factors associated with Hr-TB, we recommend screening all bacteriologically confirmed TB cases for INH resistance at baseline.</p>\",\"PeriodicalId\":46239,\"journal\":{\"name\":\"Public Health Action\",\"volume\":\"15 2\",\"pages\":\"76-81\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143246/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health Action\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5588/pha.25.0002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Action","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5588/pha.25.0002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
背景：耐异烟肼、利福平敏感的结核分枝杆菌（Hr-TB）是最常见的耐药结核（DR-TB）。我们调查了埃塞俄比亚Hr-TB的患病率和危险因素。方法：开展一项横断面研究，以确定Hr-TB的规模，并将Hr-TB患者的特征与2017-2019年国家耐药性调查期间发现的耐多药结核病（MDR-TB）和INH/ rmp敏感结核病患者的特征进行比较。结果：从肺结核患者中分离出的1927株结核分枝杆菌中，Hr-TB的患病率为4.1% (95% CI 3.2-5.1)，而MDR-TB的患病率为1.9%。（95% ci 1.3-2.6）。与耐多药结核病不同的是，新发结核病例和以前治疗过的结核病例之间，耐药结核的发病率没有显著差异（P = 0.67）。阿姆哈拉地区（8.0%,95% CI 4.8-12.5）和亚的斯亚贝巴地区（7.1%,95% CI 3.4-13.0）的Hr-TB病例患病率较高。Hr-TB的比例随着年龄的增长而增加(OR 1.02, 95% CI 1.01-1.04；P = 0.035)。与INH/ rmp易感结核相比，Hr-TB更容易对乙胺丁醇、链霉素和吡嗪酰胺产生耐药性（P < 0.0001）。结论：Hr-TB是埃塞俄比亚最流行的耐药结核病类型，在区域各州之间存在差异。鉴于缺乏与Hr-TB相关的可识别的临床因素，我们建议在基线时对所有细菌学证实的结核病病例进行INH耐药性筛查。
Isoniazid-resistant TB and associated factors in Ethiopia.
Background: Isoniazid-resistant, rifampicin-susceptible Mycobacterium tuberculosis (Hr-TB) is the most common form of drug-resistant TB (DR-TB). We investigated the prevalence of and risk factors for Hr-TB in Ethiopia.
Methods: A cross-sectional study was conducted to determine the magnitude of Hr-TB, and to compare characteristics of persons with Hr-TB to those with multidrug-resistant TB (MDR-TB) and INH/RMP-susceptible TB identified during the National Drug Resistance Survey from 2017-2019.
Results: Among 1927 M. tuberculosis isolates recovered from persons with pulmonary TB, the prevalence of Hr-TB was 4.1% (95% CI 3.2-5.1), whereas the prevalence of MDR-TB was 1.9%. (95% CI 1.3-2.6). Unlike MDR-TB, the occurrence of Hr-TB did not differ significantly between new and previously treated TB cases (P = 0.67). The prevalence of Hr-TB cases was high in the Amhara (8.0%, 95% CI 4.8-12.5) region and Addis Ababa (7.1%, 95% CI 3.4-13.0). The proportion of Hr-TB increased with age (OR 1.02, 95% CI 1.01-1.04; P = 0.035). Compared to INH/RMP-susceptible TB, Hr-TB was more likely to harbor resistance to ethambutol, streptomycin and pyrazinamide (P < 0.0001).
Conclusions: Hr-TB is the most prevalent type of DR-TB in Ethiopia and varies among regional states. Given the lack of identifiable clinical factors associated with Hr-TB, we recommend screening all bacteriologically confirmed TB cases for INH resistance at baseline.
期刊介绍：
Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
