Ejeta Eyasu, Chala Muda, Arega Gebeyaw, Ayalsew Kassahu, Tesfaye Lensa, Birhanu Tadesse, Disassa Haimanot
College of Medical and Health Sciences, Wollega University, Nekemte, Ethiopia.
J Infect Dev Ctries. 2015 Jul 30;9(7):752-9. doi: 10.3855/jidc.5963.
Treatment outcome is an important indicator of tuberculosis control programs, as suggested by the World Health Organization. However, this has not been well documented in the study area. This work contributes to a better understanding this issue.
A five-year (2009-2013) retrospective cohort study was conducted between April and May 2014, in six randomly selected health institutions providing tuberculosis treatment in western Ethiopia. Bivariate and multivariate logistic regression analyses were used to assess the association between treatment outcomes and predictor variables.
A total of 1,175 tuberculosis patients with a mean (standard deviation) age of 29.91 (13.99) were involved in the study. The majority of the study participants had smear-negative pulmonary tuberculosis (39.7%) and extrapulmonary tuberculosis (39.7%). Of all the study participants, 14.5% were cured, 56.3% completed treatment, 0.2% had treatment failure, 8.1% died during follow-up, 7.1% were reported as defaulters, and 13.8% were transferred out to another health institution. The overall treatment success rate was 70.8% and show progressive increases over the course of the study. The associated predictors were enrollment years, HIV co-infection, and sputum smear follow-up in the second, fifth, and seven months.
The treatment success rate was unsatisfactory in spite of improvement seen over the study period. Thus, continued follow-up of patients, with frequent supportive supervision during the course of treatment, and provision of early detection and follow-up for HIV infection need to be strengthened to achieve an effective treatment outcome.
世界卫生组织指出,治疗结果是结核病控制项目的一项重要指标。然而,在该研究区域,这方面的记录并不完善。本研究有助于更好地理解这一问题。
2014年4月至5月,在埃塞俄比亚西部随机选取的六家提供结核病治疗的医疗机构开展了一项为期五年(2009 - 2013年)的回顾性队列研究。采用双变量和多变量逻辑回归分析来评估治疗结果与预测变量之间的关联。
共有1175例结核病患者参与研究,平均(标准差)年龄为29.91(13.99)岁。大多数研究参与者患有涂片阴性肺结核(39.7%)和肺外结核(39.7%)。在所有研究参与者中,14.5%治愈,56.3%完成治疗,0.2%治疗失败,8.1%在随访期间死亡,7.1%被报告为失访,13.8%被转至另一家医疗机构。总体治疗成功率为70.8%,且在研究过程中呈逐步上升趋势。相关预测因素为入组年份、HIV合并感染以及在第二个月、第五个月和第七个月的痰涂片随访情况。
尽管在研究期间有所改善,但治疗成功率仍不尽人意。因此,需要加强对患者的持续随访,在治疗过程中进行频繁的支持性监督,并加强对HIV感染的早期检测和随访,以实现有效的治疗效果。