NGHIÊN CỨU MỘT SỐ YẾU TỐ NGUY CƠ CỦA LAO PHỔI KHÁNG RIFAMPICIN TẠI TỈNH THỪA THIÊN HUẾ

Abstract

Objectives: 1. Describe the clinical and subclinical characteristics of patients with pulmonary tuberculosis resistant to rifampicin. 2. Some risk factors in patients with pulmonary tuberculosis resistant to rifampicin.

Subjects and methods: A cross-sectional descriptive study on 157 tuberculosis patients diagnosed by Xpert MTB/RIF test at the Department of Lung Diseases, Hue Central Hospital and Thua Thien Hue Lung Hospital from January 2021 to September 2022.

Results: Males accounted for the majority of the rifampicin-resistant pulmonary tuberculosis group (90.3%), average age: 48.19 ± 2,997, BMI ≤ 18.5 kg/m2 (61.3%), with history treated with anti-tuberculosis drugs (64.5%). Clinical features: fatigue (74.2%), anorexia (71%), weight loss (71%), persistent cough and expectoration (77.4%), shortness of breath (51.6%), chest pain (67.7%), hemoptysis (16.1%). Most rifampicin-resistant pulmonary tuberculosis had rales in the lungs (80.6%). Subclinical features: Sputum AFB test is usually positive (64.5%) with positivity levels of 1+ (45%), 2+ (30%), 3+ (20%). The extent of lesions according to ATS on straight chest radiographs is commonly found at level II (45.2%), level III (48.4%). The location of the lesion tends to be diffuse (51.6%). lesions: Infiltrative (96.8%), fibrous (51.6%), nodular (19.4%), cavernous (41.9%). There was an association between rifampicin-resistant pulmonary TB and a history of TB treatment (OR = 10.557, 95% CI: 3.263 - 34.150), rales in the lungs (OR = 4.159, 95% CI: 1.016 - 17.031), cavernous lesions (OR = 6.415, 95% CI: 1.819 - 22.624) and nodules (OR = 10.649, 95% CI: 1.438 - 78.846) on straight chest radiographs.

Conclusions: There is an association between rifampicin-resistant pulmonary tuberculosis and a history of TB treatment, with physical symptoms in the lungs, with cavity or nodular lesions on the chest radiograph.