Molina Rueda M J, Fernández Ajuria A, Rodríguez Del Águila M M, López Hernández B
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Virgen de las Nieves, Granada, España.
Rev Clin Esp. 2012 Sep;212(8):383-8. doi: 10.1016/j.rce.2012.03.013. Epub 2012 May 18.
The factors associated to tuberculosis (TB) treatment drop-out can be very specific to the population and the local health care organization. We have studied the factors associated to TB treatment drop out in the province of Granada.
A retrospective cohort study of TB cases registered in the province of Granada by the Epidemiological Surveillance System of Andalusia (SVEA) between 2003 and 2010 was carried out. Incidence was calculated in the native and foreign population. An univariate analysis was performed to describe the characteristics in both groups and a logistic regression model was used to identify factors associated to therapeutic abandonment.
A decreasing trend in the incidence of TB was observed, (20.47 in 2007 to 11 cases per 100,000 inhabitants in 2010, respectively. Mean age of foreign patients was lower than that of the natives (30.8 years vs. 46.0 years, P<.001). The former predominately lived in the Granada district, while the natives lived in the Metropolitan district. The percentage of patients who abandoned antituberculous treatment was 12.2%, this being somewhat higher in the foreign patients than the national ones (14% vs 10%; P=.062). Being male (OR: 1.65; 95% CI: 1.04-2.60; P=.033), foreigner (OR: 1.72; 95% CI: 1.04-2.83; P=.032), resident in the North-east district (OR: 3.64; 95% CI: 1.76-7.52; P=.005) and/or having extrapulmonary TB (OR: 1.78; 95% CI: 1.06-3.00; P=.029) were associated significantly to therapeutic abandonment.
The incidence of TB in the province of Granada has decreased to about 10 cases per 100,000 inhabitants/year. The percentage of patients who abandon TB treatment is significant, it being higher in foreign patients than in the natives. TB treatment abandonment was associated to being a man, living in the North-east district of Granada and having extrapulmonary TB.
与结核病(TB)治疗中断相关的因素可能因人群和当地医疗保健机构而异。我们研究了格拉纳达省与结核病治疗中断相关的因素。
对安达卢西亚省流行病学监测系统(SVEA)在2003年至2010年间登记的格拉纳达省结核病病例进行回顾性队列研究。计算本地人和外国人的发病率。进行单因素分析以描述两组的特征,并使用逻辑回归模型确定与治疗中断相关的因素。
观察到结核病发病率呈下降趋势(2007年为20.47例,2010年为每10万居民11例)。外国患者的平均年龄低于本地人(30.8岁对46.0岁,P<0.001)。前者主要居住在格拉纳达区,而本地人居住在都会区。放弃抗结核治疗的患者比例为12.2%,外国患者略高于本国患者(14%对10%;P=0.062)。男性(比值比:1.65;95%置信区间:1.04 - 2.60;P=0.033)、外国人(比值比:1.72;95%置信区间:1.04 - 2.83;P=0.032)、居住在东北区(比值比:3.64;95%置信区间:1.76 - 7.52;P=0.005)和/或患有肺外结核(比值比:1.78;95%置信区间:1.06 - 3.00;P=0.029)与治疗中断显著相关。
格拉纳达省的结核病发病率已降至每年每10万居民约10例。放弃结核病治疗的患者比例较高,外国患者高于本国患者。结核病治疗中断与男性、居住在格拉纳达东北区以及患有肺外结核有关。