Gafar Mohammed M, Nyazema Norman Z, Dambisya Yoswa M
Department of Pharmacy, School of Health Sciences, University of Limpopo.
Curationis. 2014;37(1):e1-e7. doi: 10.4102/curationis.v37i1.1169. Epub 2014 Nov 27.
South Africa has a high burden of tuberculosis (TB), with high human immunodeficiency virus (HIV)-TB co-infection rates and the emergence of multidrugresistant TB.
To describe treatment outcomes and factors influencing outcomes amongst pulmonary TB (PTB) patients in the Limpopo Province.
A retrospective review was conducted of data on the provincial electronic TB register (ETR.net) for the years 2006 to 2010 (inclusive), and a random sample of 1200 records was selected for further analysis. The Chi square test was used to examine the influence of age, gender, health facility level, diagnostic category and treatment regimen on treatment outcomes.
Overall 90 617 (54.6% male) PTB patients were registered between 2006 and 2010. Of the sampled 1200 TB cases, 72.6% were in persons aged 22 to 55 years and 86.2% were new cases. The TB mortality rate was 13.6% (much higher than the World Health Organization target of 3%), whilst the default rate was 9.8%. There was a strong association between age (P < 0.001), diagnostic category (P < 0.001), treatment regimen (P < 0.001), and health facility level (P < 0.001) and treatment outcome. Those aged 22–55, and 56–74 years were more likely to die (P < 0.05). Poor treatment outcomes were also associated with initial treatment failure, receiving treatment at hospital and treatment regimen II.
The poor TB treatment outcomes in Limpopo, characterised by a high mortality and default rates, call for strengthening of the TB control programme, which should include integration of HIV and/or AIDS and TB services.
南非结核病负担沉重,人类免疫缺陷病毒(HIV)与结核病合并感染率高,且出现了耐多药结核病。
描述林波波省肺结核(PTB)患者的治疗结果及影响结果的因素。
对2006年至2010年(含)省级电子结核病登记册(ETR.net)的数据进行回顾性分析,并随机抽取1200条记录进行进一步分析。采用卡方检验来研究年龄、性别、医疗机构级别、诊断类别和治疗方案对治疗结果的影响。
2006年至2010年期间,共登记了90617例PTB患者(男性占54.6%)。在抽取的1200例结核病病例中,72.6%的患者年龄在22至55岁之间,86.2%为新病例。结核病死亡率为13.6%(远高于世界卫生组织设定的3%的目标),而违约率为9.8%。年龄(P < 0.001)、诊断类别(P < 0.001)、治疗方案(P < 0.001)以及医疗机构级别(P < 0.001)与治疗结果之间存在密切关联。年龄在22 - 55岁以及56 - 74岁的患者死亡可能性更高(P < 0.05)。治疗效果不佳还与初始治疗失败、在医院接受治疗以及治疗方案II有关。
林波波省结核病治疗效果不佳,死亡率和违约率居高不下,这就需要加强结核病控制项目,其中应包括整合HIV和/或艾滋病与结核病服务。