Mbatchou Ngahane B H, Dahirou F, Tchieche C, Wandji A, Ngnié C, Nana-Metchedjin A, Nyankiyé E, Endale Mangamba M L, Kuaban C
Department of Internal Medicine, Douala General Hospital, Douala, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala.
Department of Internal Medicine, Douala General Hospital, Douala.
Int J Tuberc Lung Dis. 2016 Dec 1;20(12):1609-1614. doi: 10.5588/ijtld.15.0731.
Tuberculosis (TB) clinic, Douala Laquintinie Hospital, Douala, Cameroon.
To describe the clinical characteristics of TB and to investigate predictors of poor treatment outcomes.
A registry-based, retrospective cohort study of all TB cases recorded from 2007 to 2013 was conducted. Multinomial logistic regression models were used to identify predictors of poor outcomes.
Of 8902 TB cases included, 5110 (57.4%) were males. The median age was 33 years. The prevalence of human immunodeficiency virus (HIV) infection was 37.6%, with a significant decline over the study years (P = 0.000). The main clinical form of TB was smear-positive TB (50.5%). The treatment success rate was 75.2%, while the mortality rate was 8.1%. The year of TB diagnosis, retreatment cases, sputum non-conversion at the end of month 2, HIV infection and HIV testing not done were associated with death. Retreatment and non-conversion of sputum were associated with treatment failure, while male sex, age, sputum non-conversion, HIV infection and HIV testing not done were associated with loss to follow-up.
TB management objectives may be attained by focusing specifically on higher risk groups to prevent poor treatment outcomes.
喀麦隆杜阿拉拉昆蒂尼医院结核病诊所。
描述结核病的临床特征并调查治疗效果不佳的预测因素。
对2007年至2013年记录的所有结核病病例进行基于登记的回顾性队列研究。采用多项逻辑回归模型确定不良结局的预测因素。
纳入的8902例结核病病例中，5110例（57.4%）为男性。中位年龄为33岁。人类免疫缺陷病毒（HIV）感染率为37.6%，在研究期间显著下降（P = 0.000）。结核病的主要临床类型为涂片阳性结核病（50.5%）。治疗成功率为75.2%，死亡率为8.1%。结核病诊断年份、复治病例、第2个月末痰菌未转阴、HIV感染以及未进行HIV检测与死亡相关。复治和痰菌未转阴与治疗失败相关，而男性、年龄、痰菌未转阴、HIV感染以及未进行HIV检测与失访相关。
通过特别关注高危人群以预防治疗效果不佳，可实现结核病管理目标。
