Tolosie Kabtamu, Sharma M K
Addis Ababa University, Addis Ababa, Ethiopia.
Tuberc Res Treat. 2014;2014:536976. doi: 10.1155/2014/536976. Epub 2014 Jan 12.
Introduction. Tuberculosis (TB) is a chronic infectious disease and mainly caused by mycobacterium tuberculosis (MTB). It has been one of the major causes of mortality in Ethiopia. The objective of the study was to identify factors that affect the survival of the patients with tuberculosis who started treatment for tuberculosis. Methods. This was a retrospective study in six randomly selected health centres in Addis Ababa, Ethiopia. The data were obtained from medical records of TB patients registered from September 2012 to August 2013 and treated under directly observed treatment surgery (DOTS) strategy. Kaplan Meier plots, logrank tests, and Wilcoxon tests were used to assess the survival pattern. Cox proportional hazards model for multivariable analysis was discussed. Results. Out of the total 826 registered TB patients, 105 (12.71%) died during the study period and 712 (87.29%) were censored. Based on Kaplan Meier survival curves, logrank test, and Wilcoxon test, it was found that the patients had statistically significant differences in survival experience with respect to age, body weight at initiation of treatment, TB patient category, and HIV status. Multivariable Cox hazards regression analysis revealed that the covariates age, TB patient category, HIV, and age by HIV interaction were significant risk factors associated with death status in TB patients. Conclusion. Deaths of individuals with diseases especially HIV coinfected and nonnew TB cases were high. Therefore, this needs to strengthen the follow-up of patients with TB treatment from the day of anti-TB treatment initiation to completion days.
引言。结核病是一种慢性传染病，主要由结核分枝杆菌（MTB）引起。它一直是埃塞俄比亚主要的死亡原因之一。本研究的目的是确定影响开始接受结核病治疗的结核病患者生存的因素。方法。这是一项在埃塞俄比亚亚的斯亚贝巴随机选择的六个卫生中心进行的回顾性研究。数据来自2012年9月至2013年8月登记并在直接观察治疗策略（DOTS）下接受治疗的结核病患者的医疗记录。使用Kaplan Meier曲线、对数秩检验和Wilcoxon检验来评估生存模式。讨论了用于多变量分析的Cox比例风险模型。结果。在总共826名登记的结核病患者中，105名（12.71%）在研究期间死亡，712名（87.29%）被截尾。基于Kaplan Meier生存曲线、对数秩检验和Wilcoxon检验，发现患者在年龄、开始治疗时的体重、结核病患者类别和HIV状态方面的生存经历存在统计学显著差异。多变量Cox风险回归分析显示，协变量年龄、结核病患者类别、HIV以及年龄与HIV的相互作用是与结核病患者死亡状态相关的显著风险因素。结论。患有疾病尤其是合并感染HIV和非新发病例结核病患者的死亡率较高。因此，这需要加强从抗结核治疗开始之日到完成之日对结核病治疗患者的随访。
