Babalik A, Kiziltas S, Gencer S, Kilicaslan Z
Department of Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Kadıkoy Tuberculosis Dispensary, Turkey.
Rev Port Pneumol. 2014 Sep-Oct;20(5):248-53. doi: 10.1016/j.rppneu.2014.01.003. Epub 2014 Mar 24.
Istanbul has the highest incidence of tuberculosis (TB) in Turkey. It is also the largest city, with considerable differences in quality of life across its urban regions. The aim of this study is to investigate the relationship between (i) the diverse quality of life across specific urban regions, (ii) TB incidence rates, inclusive of demographic and clinical characteristics of TB patients, and (iii) adverse treatment outcomes.
This retrospective study included 23,845 new TB patients (recorded in the National TB Registry between 2006 and 2010) in Istanbul. Thirty-nine urban districts of Istanbul were ranked into five groups on the basis of an urban quality of life index. Patient data were matched with these groups, and further categorized according to 'age', 'sex', 'country of birth' and 'antibiotics resistance'. Adverse treatment outcomes and TB incidence rates were extracted from official records. Logistic regression, clustered analyses, 95% CI and p values (STATA) were reported to describe the association between variables.
Six per cent of total cases had 'at least one adverse treatment outcome' (default 3.8%, failure 0.5%, death 1.7% in total cases). 'An adverse treatment outcome' was found to be associated with age OR (CI 95%) (1.02 (1.01-1.03)); 'male sex' 1.65 (1.28-2.12); 'other country of birth' 4.82 (3.05-7.62); 100,000 per 'over 60' insidence goups 1.61 (1.32-1.97), the lowest quality of life index 0.65 (0.47-0.83).
Patients with high tuberculosis risk factors living in high incidence regions need to be closely monitored. Patients living in lower ranking regions are more likely to have 'poor treatment outcomes'.
伊斯坦布尔是土耳其结核病发病率最高的城市。它也是最大的城市，其不同城区的生活质量存在显著差异。本研究的目的是调查（i）特定城区不同的生活质量、（ii）结核病发病率（包括结核病患者的人口统计学和临床特征）以及（iii）不良治疗结局之间的关系。
这项回顾性研究纳入了伊斯坦布尔23845例新结核病患者（2006年至2010年记录于国家结核病登记处）。根据城市生活质量指数，伊斯坦布尔的39个城区被分为五组。患者数据与这些组进行匹配，并进一步按“年龄”“性别”“出生国家”和“抗生素耐药性”进行分类。不良治疗结局和结核病发病率从官方记录中提取。报告了逻辑回归、聚类分析、95%置信区间和p值（使用STATA软件）以描述变量之间的关联。
总病例的6%有“至少一种不良治疗结局”（总体病例中默认3.8%、治疗失败0.5%、死亡1.7%）。发现“不良治疗结局”与年龄OR（95%置信区间）（1.02（1.01 - 1.03））、“男性”1.65（1.28 - 2.12）、“其他出生国家”4.82（3.05 - 7.62）、每10万“60岁以上”发病率组1.61（1.32 - 1.97）、最低生活质量指数0.65（0.47 - 0.83）相关。
生活在高发病率地区且具有高结核病风险因素的患者需要密切监测。生活在排名较低地区的患者更有可能出现“不良治疗结局”。
