Saha Rajib
Department of Community Medicine, Bankura Sammilani Medical College & Hospital, Bankura, West Bengal 722101, India.
Tuberc Res Treat. 2016;2016:8608602. doi: 10.1155/2016/8608602. Epub 2016 Aug 30.
Objective. The study was conducted to assess the treatment outcome of different category retreatment cases with the aim of finding out the important predictors of unfavorable outcomes. Methodology. This hospital based prospective cohort study was conducted in three tuberculosis units (TUs) of west Midnapore (a district of Eastern India), covering mostly the tribal populated areas. Patients who were registered for Category II antituberculosis treatment between 1st quarter of 2013 (Jan to Mar) and 4th quarter of 2013 (Oct to Dec) were considered as our study cohort and they were followed up till December 2014. The study was started with 177 patients but ultimately ended with 165 patients. Results. Unfavorable outcome was observed among 24.8% patients. Among them mostly 51.2% were defaulter, 22% were failure case, and 26.8% died during treatment. Patients, who were minority by religion, were found 4 times more vulnerable for unfavorable outcome. Unfavorable outcome was found 7 times more common among retreatment TB cases who remain sputum positive after completion of initiation phase of Category II treatment. Conclusion. Programmatic approach should be specified to address the minority by religion population and to reduce the load of sputum positive cases after completion of initiation phase treatment by tracking them.
目的。开展本研究以评估不同类别复治病例的治疗结果,旨在找出不良结局的重要预测因素。方法。本基于医院的前瞻性队列研究在西米德纳布尔(印度东部一个地区)的三个结核病治疗单位进行,主要覆盖部落聚居地区。2013年第一季度(1月至3月)至2013年第四季度(10月至12月)期间登记接受II类抗结核治疗的患者被视为我们的研究队列,并随访至2014年12月。研究起始有177名患者,但最终有165名患者完成研究。结果。24.8%的患者出现不良结局。其中,大部分(51.2%)为失访者,22%为治疗失败病例,26.8%在治疗期间死亡。宗教上属于少数群体的患者出现不良结局的可能性高出4倍。在II类治疗强化期结束后痰菌仍呈阳性的复治结核病病例中,不良结局的发生率高出7倍。结论。应制定针对性方案,以应对宗教少数群体人群,并通过追踪在强化期治疗结束后痰菌阳性病例来减轻其负担。