Tachfouti Nabil, Slama Katia, Berraho Mohamed, Elfakir Samira, Benjelloun Mohammed Chakib, El Rhazi Karima, Nejjari Chakib
Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine University Sidi Mohammed Ben Abdallah, Fez, Morocco.
Pan Afr Med J. 2013 Mar 28;14:121. doi: 10.11604/pamj.2013.14.121.2335. Print 2013.
Studies have shown an association between smoking and tuberculosis (TB) infection, disease and TB-related mortality. We thus documented the impact of smoking and others factors on TB treatment default.
A cohort of 1039 new TB cases matched on smoking status was followed between 2004 and 2009 in eight Moroccan regions. Treatment default was defined according to international criteria. Univariate analyses were used to assess associations of treatment default with smoking status and demographic characteristics. Multivariate logistic regression was used to adjust for potential confounding.
Patients' mean age was 35.0 ±13.2 years. The rate of treatment default was 30.2%. Default was significantly higher among men, smokers, persons living in urban areas and non-religious Muslims. After adjusting for confounding variables, factors that remained significantly associated with treatment default were: being male (OR = 3.2; 95% CI: 1.2-8.7), being a non-religious Muslim (OR = 2.0; 95% CI: 1.4-2.9) and living in an urban area OR = 3.0; 95% CI: 1.8-4.9).
The high rate found for default suggests important program's inadequacies and an urgent need for change. Therefore continued research of predictors of default and strategies to reinforce adherence is recommended.
研究表明吸烟与结核病感染、疾病及结核病相关死亡率之间存在关联。因此，我们记录了吸烟及其他因素对结核病治疗中断的影响。
2004年至2009年期间，在摩洛哥的八个地区对1039例新确诊的结核病病例按吸烟状况进行匹配跟踪。治疗中断根据国际标准定义。采用单因素分析评估治疗中断与吸烟状况及人口统计学特征之间的关联。采用多因素逻辑回归对潜在混杂因素进行校正。
患者的平均年龄为35.0±13.2岁。治疗中断率为30.2%。男性、吸烟者、城市居民和非宗教穆斯林的治疗中断率显著更高。在校正混杂变量后，与治疗中断仍显著相关的因素有：男性（比值比=3.2；95%置信区间：1.2 - 8.7）、非宗教穆斯林（比值比=2.0；95%置信区间：1.4 - 2.9）以及居住在城市地区（比值比=3.0；95%置信区间：1.8 - 4.9）。
发现的高治疗中断率表明该项目存在重大不足，迫切需要变革。因此，建议继续研究治疗中断的预测因素及加强依从性的策略。
