Itogo N, Hill P C, Bissell K, Harries A D, Viney K, Gounder S
Ministry of Health and Medical Services, Honiara, Solomon Islands.
Centre for International Health, University of Otago, Dunedin, New Zealand.
Public Health Action. 2014 Jun 21;4(Suppl 1):S25-8. doi: 10.5588/pha.13.0078.
All provincial tuberculosis (TB) management units in the Solomon Islands.
To compare TB notifications, characteristics and treatment outcomes in urban vs. rural areas.
A retrospective descriptive cohort study involving record review and data extraction from provincial TB and laboratory registers and treatment charts from 2000 to 2011.
Of 4137 TB cases notified, 1364 (33%) were from urban and 3227 (67%) from rural areas. Notification rates per year of study were consistently higher in urban areas (104-150 per 100 000 population) than in rural areas (49-70/100 000). Cases in rural areas were more likely to have smear-negative pulmonary TB and less likely to have extra-pulmonary TB (P < 0.001). TB cases in rural areas were more likely to die from TB than those from urban areas (3.2% vs. 5.9%). In contrast, TB cases in rural areas were less likely to default (2.8% vs. 1.8%).
TB notification rates were much higher in urban than in rural areas in the Solomon Islands. Rural patients are more likely to die from the disease but are slightly less likely to default. Further research is required to explore the possibility of under-reporting in rural areas and to improve treatment outcomes.
所罗门群岛所有省级结核病管理单位。
比较城市和农村地区的结核病报告情况、特征及治疗结果。
一项回顾性描述性队列研究，涉及对2000年至2011年省级结核病和实验室登记册以及治疗图表的记录审查和数据提取。
在所报告的4137例结核病病例中，1364例（33%）来自城市，3227例（67%）来自农村。研究期间每年城市地区的报告率（每10万人口104 - 150例）始终高于农村地区（每10万人口49 - 70例）。农村地区的病例更有可能患涂片阴性肺结核，患肺外结核的可能性较小（P < 0.001）。农村地区的结核病病例比城市地区的病例更有可能死于结核病（3.2%对5.9%）。相比之下，农村地区的结核病病例违约的可能性较小（2.8%对1.8%）。
在所罗门群岛，城市地区的结核病报告率远高于农村地区。农村患者死于该病的可能性更大，但违约的可能性略小。需要进一步研究以探讨农村地区报告不足的可能性并改善治疗结果。
