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[2012年哥伦比亚麦德林市结核病所致死亡率分析]

[Analysis of mortality caused by tuberculosis in Medellín, Colombia, 2012].

作者信息

Villa Liliana, Trompa Iván Mauricio, Montes Fernando Nicolás, Gómez Joaquín Guillermo, Restrepo Carlos Andrés

机构信息

Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.

Programa de Control de Tuberculosis y Lepra, Secretaría de Salud de Medellín, Medellín, Colombia.

出版信息

Biomedica. 2014 Jul-Sep;34(3):425-32. doi: 10.1590/S0120-41572014000300012.

Abstract

INTRODUCTION

Tuberculosis is a relevant global public health problem. Although reports of the World Health Organization show decrease in overall mortality rates, Colombia and Medellin show no significant decline.

OBJECTIVE

To describe the sociodemographic, clinical, diagnosis, and treatment characteristics of patients who died due to tuberculosis in Medellin, Colombia, during 2012.

MATERIALS AND METHODS

A descriptive study of tuberculosis deaths reported in the city.

RESULTS

93 deaths were identified, of which 32 were confirmed as directly caused by tuberculosis (34.4%); in 23 deaths (24.7%) tuberculosis was an associated cause. Co-morbidities were found in 34 patients (61.7%), HIV being the most common with 18 cases important(32.7%). Social risk factors such as being homeless, drug addiction or having no fixed address were found in 32 cases (58.1%); and there were deficiencies in the healthcare system in 26 cases (47.2%). No meaningful delay in the onset of anti-tuberculosis treatment was found after the microbiological diagnosis; however, 64% of patients did not adhere to treatment.

CONCLUSION

Mortality caused by tuberculosis in Medellin is a relevant problem associated with delays in diagnosis of the disease and lack of adherence to treatment.

摘要

引言

结核病是一个重大的全球公共卫生问题。尽管世界卫生组织的报告显示总体死亡率有所下降,但哥伦比亚和麦德林并未出现显著下降。

目的

描述2012年哥伦比亚麦德林因结核病死亡患者的社会人口统计学、临床、诊断和治疗特征。

材料与方法

对该市报告的结核病死亡病例进行描述性研究。

结果

共确定93例死亡病例,其中32例被确认为直接由结核病导致(34.4%);23例死亡病例(24.7%)中结核病为相关病因。34例患者(61.7%)存在合并症,其中最常见的是艾滋病病毒感染,有18例(32.7%)。32例患者(58.1%)存在社会风险因素,如无家可归、吸毒或无固定住址;26例患者(47.2%)存在医疗系统缺陷。微生物学诊断后未发现抗结核治疗开始有明显延迟;然而,64%的患者未坚持治疗。

结论

麦德林结核病导致的死亡率是一个与疾病诊断延迟和治疗依从性差相关的重大问题。

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