印度新德里治疗儿童肺结核的直接观察短程化疗策略。

The DOTS strategy for treatment of paediatric pulmonary tuberculosis in South Delhi, India.

作者信息

Sharma S, Sarin R, Khalid U K, Singla N, Sharma P P, Behera D

机构信息

Department of Paediatric Pulmonology, Lala Ram Sarup (LRS) Institute of Tuberculosis & Respiratory Diseases, New Delhi, India.

出版信息

Int J Tuberc Lung Dis. 2008 Jan;12(1):74-80.

PMID:18173881

Abstract

SETTING

Paediatric Pulmonology Department, TB Institute, New Delhi, India.

OBJECTIVE

To evaluate the outcome of the DOTS strategy for paediatric pulmonary tuberculosis (TB).

DESIGN

Retrospective analysis of 1098 children.

RESULTS

The mean age of the children included in the study was 11.2 years, with more females (61.7%) than males (38.3%). In the 0-5, 6-10 and 11-14 year age groups, the percentage of patients was respectively 18.3%, 26.6% and 55.1%. Patients were registered as new cases (87.7%), relapses (1.9%), failures (1.0%), defaulters (5.0%), transferred in (0.9%) and others (3.5%). Of the total number of cases, 414 were smear-positive and 404 smear-negative, while sputum status was not known for 280 patients. Sputum positivity increased with age. Category I, II and III regimens were started by respectively 50.6%, 10.5% and 38.9% patients. The cure rate was 92.4% (302/327) for new and 92% (80/87) for retreatment cases (chi(2)(1) = 0.02, P = 0.901), but the treatment completion rate was significantly higher for new cases (97%, 636/656) than retreatment cases (53.6%, 15/28) (chi(2)(1) = 100.8, P < 0.001). The overall success rate was 95.4% and 82.6% for new and retreatment cases, respectively (chi(2)(1) = 30.35, P < 0.001). Overall, the rates for default, failure and death in the study were respectively 3%, 1.9% and 1%.

CONCLUSION

DOTS appears to be a highly efficacious treatment strategy.

摘要

背景

印度新德里结核病研究所儿科肺病科。

目的

评估直接观察短程治疗（DOTS）策略用于儿童肺结核（TB）的治疗效果。

设计

对1098名儿童进行回顾性分析。

结果

纳入研究的儿童平均年龄为11.2岁，女性（61.7%）多于男性（38.3%）。在0 - 5岁、6 - 10岁和11 - 14岁年龄组中，患者所占百分比分别为18.3%、26.6%和55.1%。患者登记为新病例（87.7%）、复发（1.9%）、治疗失败（1.0%）、中断治疗（5.0%）、转入（0.9%）及其他（3.5%）。在所有病例中，414例痰涂片阳性，404例痰涂片阴性，280例患者痰检情况未知。痰涂片阳性率随年龄增长而升高。分别有50.6%、10.5%和38.9%的患者开始采用I类、II类和III类治疗方案。新病例治愈率为92.4%（302/327），复治病例治愈率为92%（80/87）（χ²(1)=0.02，P = 0.901），但新病例的治疗完成率（97%，636/656）显著高于复治病例（53.6%，15/28）（χ²(1)=100.8，P < 0.001）。新病例和复治病例的总体成功率分别为95.4%和82.6%（χ²(1)=30.35，P < 0.001）。总体而言，本研究中的中断治疗率、治疗失败率和死亡率分别为3%、1.9%和1%。