文章摘要
杨本付,徐飚,蒋伟利,周佩源,姜庆五.苏北农村耐药结核病现状及影响因素的研究[J].中华流行病学杂志,2004,25(7):582-585
苏北农村耐药结核病现状及影响因素的研究
Study on the epidemiology and determ inants of drug-resistant tuberculosis in northern rural area of Jiangsu province
投稿时间:2003-10-28  
DOI:
中文关键词: 结核病;耐药性;直接面视下短程化疗;影响因素
英文关键词: Tuberculosis;Drug-resistance;Determinant;Directly observed treatment short-cour
基金项目:
作者单位E-mail
杨本付 复旦大学公共卫生学院流行病学教研室 上海 200032  
徐飚 复旦大学公共卫生学院流行病学教研室 上海 200032  
蒋伟利 复旦大学公共卫生学院流行病学教研室 上海 200032  
周佩源 复旦大学公共卫生学院流行病学教研室 上海 200032  
姜庆五 复旦大学公共卫生学院流行病学教研室 上海 200032 qwjiang@shmu.edu.cn 
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中文摘要:
      目的 探讨农村耐药结核病的流行现状与可能的危险因素及保护因素.方法 对实施直接面视下短程化疗(DOTS)的苏北某项目县2002年全部结核病患者和某非项目县同期患者的-个样本进行问卷调查和痰菌培养,对新分离株进行比例法药敏试验,以单因素及多因素非条件logistic回归方法分析资料.结果 共有152例患者的药敏结果可以分析.其中32.9%的病例耐至少1种-线药,26.3%耐异胭肼(INH),18.4%耐利福平(RIF),17.1%同时耐INH和RIF.INH耐药和RIF耐药共同的独立危险因素是结核病治疗史和来自非项目县,而不重视自身健康和就医延误1个月以上的患者更可能耐RIF.耐多药(MDR)的独立预告因素包括:就医延误1个月以上(OR=4.66,95%CI:1.26~17.24)、来自非项目县(OR=3.01,95%CI:1.10~8.22)、不重视健康(OR=5.13,95%CI:1.06~24.90)和患有慢性病(OR=0.22,95%CI:0.05~0.87).结论 当地农村耐药结核病疫情严重,耐药性主要与人为因素有关,但可能存在-定的传播.
英文摘要:
      Objective to understand the determinants and epidemiology of drug-resistant tuberculosis(TB)in rural area.Methods AIl the diagnosed TB patients in a county with directly observed treatment(DOTS)short-course program in 2002 and a sample of patients in another county without DOTS program located in northern Jiangsu province were surveyed with questionnaires.Drug susceptibility testing(DST)for positive cultures were perform ed by standardized proportion method.Univariable analysis and multivariate nonconditional logistic regression mod eling were applied for data analysis.Results Among the 152 patients with DST Results.32.9% of the cases showed resistance to at least one of the first-line anti-tuberculosis drugs with 26.3% to isoniazid, 18.4% to rifampin and 17.1% to both isoniazid and rifampin respectively.Previous treatments for TB and residence in the county without DoTS program were independent risk factors for isoniazid and rifampin resistance.TB patients showing indifferent to their health and delayed health seeking for more than 1 month were more likely to have rifampin resistance.Independent predictors of multidrug-resistant TB would include delayed health seeking for more than 1 month(OR=4.66,95%CI:1.26-17.24),residing in the county without a D0TS program (OR=3.01,95%CI:1.10-8.22),indiference to their health condition(OR=5.13, 95%CI:1.06-24.90)and suffering from chronic diseases(oR=0.22,95% CI:0.05-0.87) Conclusion Drug-resistant TB was quite serious in this rural areas,mainly associated with man-made factors but partly due to the availability of the transmission.
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