Anyama N, Bracebridge S, Black C, Niggebrugge A, Griffin S J
Department of Pharmacy, Faculty of Medicine Makerere University, Kampala, Uganda.
Epidemiol Infect. 2007 Oct;135(7):1069-76. doi: 10.1017/S0950268807007996. Epub 2007 Feb 9.
We examined different patient outcomes following diagnosis of tuberculosis (TB). Incident cases were reported to the enhanced surveillance system in the East of England, between 2000 and 2003. For the 575 cases reported in 2001 and 2002, outcomes were assessed 1 year after initiating treatment. The crude clinical incidence rate of TB was 6.0 cases/100,000 person-years (pyr) [95% confidence interval (CI) 5.7-6.4], highest in the 25-29 years age group (14.9, 95% CI 12.9-17.1 cases/100,000 pyr) and among Black Africans (328.6, 95% CI 286.9-374.6 cases/100,000 pyr). Patients born abroad were 2.35 (95% CI 1.03-5.32) times more likely to be lost to follow-up than those born in the United Kingdom. Age at diagnosis (OR 1.05, 95% CI 1.04-1.07) and pulmonary disease (OR 2.73, 95% CI 1.21-6.15) were independently associated with mortality. Elderly patients and those with pulmonary TB appear to have worse outcomes despite treatment. Foreign-born patients may need closer follow-up to ensure favourable outcomes.
我们研究了肺结核(TB)诊断后的不同患者结局。2000年至2003年间,新发病例报告给了英格兰东部的强化监测系统。对于2001年和2002年报告的575例病例,在开始治疗1年后评估结局。结核病的粗临床发病率为6.0例/100,000人年(pyr)[95%置信区间(CI)5.7 - 6.4],在25 - 29岁年龄组中最高(14.9,95%CI 12.9 - 17.1例/100,000 pyr),在非洲黑人中也最高(328.6,95%CI 286.9 - 374.6例/100,000 pyr)。国外出生的患者失访的可能性是英国出生患者的2.35倍(95%CI 1.03 - 5.32)。诊断时的年龄(比值比1.05,95%CI 1.04 - 1.07)和肺部疾病(比值比2.73,95%CI 1.21 - 6.15)与死亡率独立相关。老年患者和肺结核患者尽管接受了治疗,结局似乎更差。国外出生的患者可能需要更密切的随访以确保良好的结局。