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Abstract：
BACKGROUND: Drug-resistant tuberculosis (DR-TB) is a major public health threat in Hunan Province, with an increasing clinical burden in recent years. This study aimed to identify socio-demographic and clinical factors associated with DR-TB in Hunan province, China.
METHODS: A case-control study was conducted in Hunan province. Cases were all DR-TB patients who were confirmed by culture and Drug susceptibility testing (DST) and enrolled at the DR-TB treatment center of Hunan Chest Hospital from 2013 to 2018. Controls were all Drug Susceptible TB (DS-TB) patients confirmed by DST and enrolled at the same hospital during the same period. A multivariable logistic regression model was fitted to identify factors significantly associated with DR-TB.
RESULTS: A total of 17,808 patients (15,534 DS-TB controls and 2274 DR-TB cases) were included in the study, with a mean age of 42.5 years (standard deviation (SD) ± 17.5 years) for cases and 46.1 years (SD ± 19.1 years) for controls. Age 15-64 years (Adjusted odds ratio (AOR = 1.5, 95% CI; 1.4, 1.8)), ethnic minorities (AOR = 1.5; 95% CI; 1.4, 1.8), and a history of previous TB treatment (AOR) = 1.84; 95% CI: 1.57, 2.15) was significantly associated with DR-TB. Being resident in a province outside Hunan was also a significant risk factor (AOR = 1.67; 1.27, 2.21) for DR-TB.
CONCLUSIONS: To prevent the occurrence of DR-TB in Hunan Province, interventions should be targeted at high-risk demographic groups such as ethnic minorities, individuals of productive age, and residents living outside the province. Interventions must also be targeted to previously treated cases, suggesting the appropriateness of diagnosis, treatment, and follow-up. Understanding the risk factors at the province level helps design strategies for controlling DR-TB due to variations by socioeconomic differences, quality of health care, and healthcare access.
METHODS: A case-control study was conducted in Hunan province. Cases were all DR-TB patients who were confirmed by culture and Drug susceptibility testing (DST) and enrolled at the DR-TB treatment center of Hunan Chest Hospital from 2013 to 2018. Controls were all Drug Susceptible TB (DS-TB) patients confirmed by DST and enrolled at the same hospital during the same period. A multivariable logistic regression model was fitted to identify factors significantly associated with DR-TB.
RESULTS: A total of 17,808 patients (15,534 DS-TB controls and 2274 DR-TB cases) were included in the study, with a mean age of 42.5 years (standard deviation (SD) ± 17.5 years) for cases and 46.1 years (SD ± 19.1 years) for controls. Age 15-64 years (Adjusted odds ratio (AOR = 1.5, 95% CI; 1.4, 1.8)), ethnic minorities (AOR = 1.5; 95% CI; 1.4, 1.8), and a history of previous TB treatment (AOR) = 1.84; 95% CI: 1.57, 2.15) was significantly associated with DR-TB. Being resident in a province outside Hunan was also a significant risk factor (AOR = 1.67; 1.27, 2.21) for DR-TB.
CONCLUSIONS: To prevent the occurrence of DR-TB in Hunan Province, interventions should be targeted at high-risk demographic groups such as ethnic minorities, individuals of productive age, and residents living outside the province. Interventions must also be targeted to previously treated cases, suggesting the appropriateness of diagnosis, treatment, and follow-up. Understanding the risk factors at the province level helps design strategies for controlling DR-TB due to variations by socioeconomic differences, quality of health care, and healthcare access.
摘要：
背景：耐药结核病（DR-TB）是湖南省的主要公共卫生威胁，随着近年来临床负担的增加。本研究旨在确定湖南省DR-TB相关的社会人口统计学和临床因素。中国。
方法：在湖南省进行了病例对照研究。所有病例均为2013年至2018年湖南省胸科医院DR-TB治疗中心经培养及药敏试验(DST)确诊的DR-TB患者。对照均为通过DST确认并在同一时期在同一医院登记的药物易感TB(DS-TB)患者。采用多变量逻辑回归模型来确定与DR-TB显著相关的因素。
结果：本研究共纳入17,808例患者（15,534例DS-TB对照和2274例DR-TB病例）。病例的平均年龄为42.5岁（标准差（SD）±17.5岁），对照组为46.1岁（SD±19.1岁）。年龄15-64岁（调整后优势比（AOR=1.5，95%CI；1.4，1.8）），少数民族(AOR=1.5；95%CI；1.4，1.8)，既往TB治疗史(AOR)=1.84;95%CI:1.57,2.15)与DR-TB显著相关。居住在湖南以外的省份也是DR-TB的重要危险因素（AOR=1.67；1.27，2.21）。
结论：为预防湖南省耐药结核病的发生，干预措施应针对少数民族等高危人口群体，生产年龄的个体，和居住在省外的居民。干预措施还必须针对以前治疗过的病例，表明诊断的适当性，治疗,和后续行动。了解省一级的风险因素有助于设计由于社会经济差异而导致的DR-TB控制策略。医疗保健的质量，和医疗保健。
方法：在湖南省进行了病例对照研究。所有病例均为2013年至2018年湖南省胸科医院DR-TB治疗中心经培养及药敏试验(DST)确诊的DR-TB患者。对照均为通过DST确认并在同一时期在同一医院登记的药物易感TB(DS-TB)患者。采用多变量逻辑回归模型来确定与DR-TB显著相关的因素。
结果：本研究共纳入17,808例患者（15,534例DS-TB对照和2274例DR-TB病例）。病例的平均年龄为42.5岁（标准差（SD）±17.5岁），对照组为46.1岁（SD±19.1岁）。年龄15-64岁（调整后优势比（AOR=1.5，95%CI；1.4，1.8）），少数民族(AOR=1.5；95%CI；1.4，1.8)，既往TB治疗史(AOR)=1.84;95%CI:1.57,2.15)与DR-TB显著相关。居住在湖南以外的省份也是DR-TB的重要危险因素（AOR=1.67；1.27，2.21）。
结论：为预防湖南省耐药结核病的发生，干预措施应针对少数民族等高危人口群体，生产年龄的个体，和居住在省外的居民。干预措施还必须针对以前治疗过的病例，表明诊断的适当性，治疗,和后续行动。了解省一级的风险因素有助于设计由于社会经济差异而导致的DR-TB控制策略。医疗保健的质量，和医疗保健。
