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埃塞俄比亚南部艾滋病毒感染患者中结核病的患病率及决定因素

Prevalence and determinants of Tuberculosis among HIV infected patients in south Ethiopia.

作者信息

Fekadu Sintayehu, Teshome Wondu, Alemu Getnet

机构信息

College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.

出版信息

J Infect Dev Ctries. 2015 Aug 29;9(8):898-904. doi: 10.3855/jidc.5667.

Abstract

INTRODUCTION

Tuberculosis (TB) is a chronic infectious disease that has represented a major health problem over the centuries. The human immune deficiency virus (HIV)/AIDS has substantially altered the epidemiology of TB by increasing the risk of reactivating latent TB, increasing chance of TB infection once exposed to tubercle bacilli (re-infection) and by increasing the risk of rapid progression soon after infection.

METHODOLOGY

This study employs a retrospective review analysis of patient medical records. A total of 499 HIV/AIDS patient cards were reviewed and variables were recorded. Frequencies and odds ratio were calculated to determine prevalence and associated risk factors respectively.

RESULTS

A total of 499 HIV/AIDS positive patient cards were reviewed. Ninety one (18.2%) of the study participants were found to have tuberculosis of which 20 (22%), 58 (64%) and 13 (14%) were smear positive, smear negative and extra-pulmonary tuberculosis cases, respectively. In multivariate logistic regression being female (AOR=0.39; 95% CI:0.20-0.77), WHO clinical stage 3 (AOR=5.66; 95%CI:1.79-17.94); WHO clinical stage 4 (AOR=7.89;95%CI:2.01-30.96); and functional status being ambulatory (AOR=2.22; 95%CI:1.06-4.64) were independently associated with tuberculosis-HIV co-infection with p value <0.05.

CONCLUSION

Prevalence of tuberculosis was high. Among tuberculosis positive cases, the proportion of smear negative cases was also high which requires strengthening of TB diagnostic techniques. Tuberculosis was associated with some social demographic characteristics and clinical variables.

摘要

引言

结核病是一种慢性传染病,几个世纪以来一直是主要的健康问题。人类免疫缺陷病毒(HIV)/艾滋病通过增加潜伏性结核病复发的风险、增加接触结核杆菌后感染结核病的几率(再感染)以及增加感染后快速进展的风险,极大地改变了结核病的流行病学。

方法

本研究采用对患者病历的回顾性分析。共查阅了499份HIV/艾滋病患者病历,并记录了相关变量。分别计算频率和比值比以确定患病率和相关危险因素。

结果

共查阅了499份HIV/艾滋病阳性患者病历。发现91名(18.2%)研究参与者患有结核病,其中涂片阳性、涂片阴性和肺外结核病例分别为20名(22%)、58名(64%)和13名(14%)。在多因素逻辑回归分析中,女性(比值比=0.39;95%置信区间:0.20-0.77)、世界卫生组织临床分期3期(比值比=5.66;95%置信区间:1.79-17.94)、世界卫生组织临床分期4期(比值比=7.89;95%置信区间:2.01-30.96)以及功能状态为能走动(比值比=2.22;95%置信区间:1.06-4.64)与结核病-HIV合并感染独立相关,P值<0.05。

结论

结核病患病率较高。在结核病阳性病例中,涂片阴性病例的比例也较高,这需要加强结核病诊断技术。结核病与一些社会人口学特征和临床变量相关。

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