Prevalence of pulmonary TB and spoligotype pattern of Mycobacterium tuberculosis among TB suspects in a rural community in Southwest Ethiopia
Prevalence of pulmonary TB and spoligotype pattern of Mycobacterium tuberculosis among TB suspects in a rural community in Southwest Ethiopia
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DOI：
10.1186/1471-2334-12-54
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发表时间：
2012-03-13
影响因子：
3.7
通讯作者：
Colebunders, Robert
中科院分区：
文献类型：
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作者：
Deribew, Amare;Abebe, Gemeda;Colebunders, Robert
背景资料：在埃塞俄比亚，没有强有力的监测系统，最先进的诊断设施有限，结核病的真实的负担并不为人所知。我们进行了一项以社区为基础的调查，以估计肺结核的患病率和spoligotype模式的结核分枝杆菌菌株在西南Ethiopia.Methods：共30040成人在10882家庭进行了肺结核病的Gilgel Gibe现场研究中心在埃塞俄比亚西南部。共确定了482名结核病嫌疑人，并对428名结核病嫌疑人进行了涂片镜检和培养。对所有结核病嫌疑人进行了艾滋病毒/艾滋病咨询和检测。结果：可疑结核病患者中女性占60.7%，文盲占83.6%。使用涂片显微镜检查，共发现5例新的肺结核病例和4例旧的肺结核病例，使结核病患病率为每10万人30例。然而，使用培养方法，我们发现了17例新病例，患病率为每10万人76.1例。每有4.3例未确诊的肺结核病例是通过卫生设施的被动病例检测机制确诊的。11株（64.7%）属于已知的6种孢子寡聚型：T型、哈勒姆型和中亚型（CAS）。鉴定了国际数据库（SpolDB 4）中不存在的6种新的结核分枝杆菌孢子寡聚体模式。农村居民中无HIV感染者，城市结核病可疑者中仅有5人（5.5%）HIV阳性。结论：埃塞俄比亚西南部农村社区结核病患病率较低。社区中有大量未确诊的结核病病例。然而，痰涂片阳性病例的数量非常低，因此将感染传播给他人的风险可能有限。通过社区卫生推广工作者积极发现病例，可以改善埃塞俄比亚的低病例发现率。对埃塞俄比亚结核分枝杆菌基因分型的大规模研究对于了解传播动力学、鉴定耐药菌株和设计预防策略至关重要。
Background: In Ethiopia where there is no strong surveillance system and state of the art diagnostic facilities are limited, the real burden of tuberculosis (TB) is not well known. We conducted a community based survey to estimate the prevalence of pulmonary TB and spoligotype pattern of the Mycobacterium tuberculosis isolates in Southwest Ethiopia.Methods: A total of 30040 adults in 10882 households were screened for pulmonary TB in Gilgel Gibe field research centre in Southwest Ethiopia. A total of 482 TB suspects were identified and smear microscopy and culture was done for 428 TB suspects. Counseling and testing for HIV/AIDS was done for all TB suspects. Spoligotyping was done to characterize the Mycobacterium tuberculosis isolates.Results: Majority of the TB suspects were females (60.7%) and non-literates (83.6%). Using smear microscopy, a total of 5 new and 4 old cases of pulmonary TB cases were identified making the prevalence of TB 30 per 100,000. However, using the culture method, we identified 17 new cases with a prevalence of 76.1 per 100,000. There were 4.3 undiagnosed pulmonary TB cases for every TB case who was diagnosed through the passive case detection mechanism in the health facility. Eleven isolates (64.7%) belonged to the six previously known spoligotypes: T, Haarlem and Central-Asian (CAS). Six new spoligotype patterns of Mycobacterium tuberculosis, not present in the international database (SpolDB4) were identified. None of the rural residents was HIV infected and only 5 (5.5%) of the urban TB suspects were positive for HIV.Conclusion: The prevalence of TB in the rural community of Southwest Ethiopia is low. There are large numbers of undiagnosed TB cases in the community. However, the number of sputum smear-positive cases was very low and therefore the risk of transmitting the infection to others may be limited. Active case finding through health extension workers in the community can improve the low case detection rate in Ethiopia. A large scale study on the genotyping of Mycobacterium tuberculosis in Ethiopia is crucial to understand transmission dynamics, identification of drug resistant strains and design preventive strategies.