Elliott E, Draper H R, Baitsiwe P, Claassens M M
InterSystems, Sandton, South Africa.
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Public Health Action. 2014 Sep 21;4(3):201-3. doi: 10.5588/pha.14.0029.
The Northern Cape Province has low cure rates (21%) for multidrug-resistant tuberculosis (TB). We audited the programme to identify factors affecting treatment outcomes. Cases admitted to two drug-resistant TB units from 2007 to 2009 had data extracted from clinical folders. Unfavourable treatment outcomes were found in 58% of the 272 cases. A multivariable regression analysis found that male sex was associated with unfavourable outcome (P = 0.009). Weight at diagnosis (P < 0.001) and oral drug adherence (P < 0.001) were also associated with an unfavourable outcome; however, injectable drug adherence was not (P = 0.395). Positive baseline smear and human immunodeficiency virus positive status were not associated with unfavourable outcome. Shorter, more patient-friendly regimens may go a long way to improving adherence and outcomes.
北开普省耐多药结核病的治愈率较低(21%)。我们对该项目进行了审核,以确定影响治疗结果的因素。从2007年至2009年入住两个耐药结核病治疗单位的病例中,提取了临床文件夹中的数据。在272例病例中,58%的病例治疗结果不佳。多变量回归分析发现,男性与治疗结果不佳相关(P = 0.009)。诊断时的体重(P < 0.001)和口服药物依从性(P < 0.001)也与治疗结果不佳相关;然而,注射药物依从性则不然(P = 0.395)。基线涂片阳性和人类免疫缺陷病毒阳性状态与治疗结果不佳无关。更短、对患者更友好的治疗方案可能在很大程度上有助于提高依从性和治疗结果。