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尼日利亚阿布贾联邦首都地区直接观察治疗短程疗法(DOTS)诊所中肺结核患者的趋势。

The trend of pulmonary tuberculosis in patients seen at DOTS clinics in the Federal Capital Territory, Abuja, Nigeria.

作者信息

Bassey E B, Momoh M A, Imadiyi S O, Udofia E B, Miri F S, Anukam K C, Epoke J, Benka-Coker M O, Aluyi H S A

机构信息

Department of Medical Laboratory Services, Wuse General Hospital, P. O. Box 2352, Garki, Abuja, Nigeria.

出版信息

Public Health. 2005 May;119(5):405-8. doi: 10.1016/j.puhe.2004.05.012.

Abstract

We evaluated the pattern of sputum smear positivity and assessed the effects of directly observed treatment short course (DOTS) among tuberculosis (TB) patients at the DOTS clinics in the Federal Capital Territory (FCT), Abuja. In total, 1391 patients were seen at six microscopy and treatment centres across the FCT between January and December 2003. Their sputa were screened microscopically for the presence of acid-fast bacilli (AFB) using the Ziehl-Neelsen staining technique. In total, 296 (21.3%) patients were smear positive; 201 (67.9%) were new cases and 95 (32.1%) were follow-up cases. The highest incidence of sputum smear positivity (24.8%) was found in those aged 21-30 years and the lowest incidence (6%) was found in those aged 71 years and above. No incidence of smear positivity was recorded in children aged 0-10 years. In total, 160 of the men screened were AFB positive (75% new cases, 25% follow-up cases). In comparison, 136 women were AFB positive (59.6% new cases, 40.4% follow-up cases). During the 1-year study period, two deaths were recorded. Men pose a serious threat to public health as most of the follow-up cases result in the tubercle bacilli developing resistance to available anti-TB drugs. This study demonstrated a high prevalence of infectious TB in the population screened, and therefore underlines the need for capacity building through a multisectoral approach in the fight against the disease. Cohort analysis should be the cardinal management strategy in evaluating the effectiveness of TB control through systemic follow-up and reporting of certain indicators in treatment progress and success.

摘要

我们评估了痰液涂片阳性模式,并在阿布贾联邦首都地区(FCT)的直接观察短程治疗(DOTS)诊所中评估了结核病(TB)患者接受DOTS治疗的效果。2003年1月至12月期间,在FCT的六个显微镜检查和治疗中心共诊治了1391名患者。使用萋-尼氏染色技术对他们的痰液进行显微镜检查,以筛查抗酸杆菌(AFB)的存在。总共有296名(21.3%)患者痰液涂片呈阳性;201名(67.9%)为新病例,95名(32.1%)为随访病例。痰液涂片阳性率最高(24.8%)的是21至30岁的人群,最低(6%)的是71岁及以上的人群。0至10岁的儿童未记录到涂片阳性病例。接受筛查的男性中有160人AFB呈阳性(75%为新病例,25%为随访病例)。相比之下,136名女性AFB呈阳性(59.6%为新病例,40.4%为随访病例)。在为期1年的研究期间,记录到2例死亡病例。男性对公共卫生构成严重威胁,因为大多数随访病例会导致结核杆菌对现有的抗结核药物产生耐药性。这项研究表明,在接受筛查的人群中传染性结核病的患病率很高,因此强调了通过多部门方法进行能力建设以抗击该疾病的必要性。队列分析应成为通过系统随访以及报告治疗进展和成功的某些指标来评估结核病控制效果的主要管理策略。

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