Introduction. Studies in Ethiopia have indicated that tuberculosis (TB) patient’s elapsed a long time before initiating treatment. Gap Statement. However, there is very limited evidence on the association of treatment initiation delay with drug resistance. Research Aim. To investigate the association of delayed treatment initiation with drug resistance among newly diagnosed TB patients in Tigray, Ethiopia. Methods. We conducted a follow-up study from October 2018 to June 2020 by recruiting 875 pulmonary tuberculosis (PTB) patients from 21 randomly selected health facilities. Delays to initiate treatment and drug resistance were collected using a standardized questionnaire and standard laboratory investigation. The association of delay to initiate treatment with acquired drug resistance was modelled using penalized maximum-likelihood (PML) regression models. Data were analysed using stata software version 15. Statistical significance was reported whenever the P-value was less than 0.05. Result. The median total delay to treatment initiation was 62 days with an inter-quartile range of 16–221 days. A unit change in time to initiate treatment reduced the risk of acquired drug resistance by 3 %. Being smear-positive at the end of treatment and after 2 months of treatment initiation were significantly associated with a higher risk of acquired drug resistance. Whereas, having a mild clinical condition was associated with a lower risk of drug resistance. Conclusion. Time to treatment initiation delay is associated with an increased risk of the emergence of drug resistance. Efforts targeted towards reducing the negative effects of PTB should focus on reducing the length of delay to initiate treatment.

中文翻译：

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埃塞俄比亚北部提格雷的新成年结核病患者开始治疗的延迟和耐药性的出现

介绍。埃塞俄比亚的研究表明，结核病患者在开始治疗之前已经过去了很长时间。 差距声明。然而，关于治疗开始延迟与耐药性之间关系的证据非常有限。 研究目的。旨在调查埃塞俄比亚提格雷新诊断结核病患者延迟开始治疗与耐药性的关系。 方法。我们从 2018 年 10 月至 2020 年 6 月进行了一项随访研究，从 21 个随机选择的卫生机构招募了 875 名肺结核 (PTB) 患者。使用标准化问卷和标准实验室调查收集延迟开始治疗和耐药性的情况。使用惩罚最大似然（PML）回归模型对延迟开始治疗与获得性耐药之间的关联进行建模。使用stata软件版本15分析数据。只要P值小于0.05， 就报告统计显着性。结果。开始治疗的中位总延迟时间为 62 天，四分位数范围为 16-221 天​​。开始治疗的时间每改变一个单位，获得性耐药性的风险就会降低 3%。治疗结束时和治疗开始 2 个月后涂片呈阳性与获得性耐药的较高风险显着相关。然而，轻度临床症状与较低的耐药风险相关。 结论。治疗开始时间的延迟与出现耐药性的风险增加相关。旨在减少 PTB 负面影响的努力应集中于缩短开始治疗的延迟时间。