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埃塞俄比亚西北部贡德尔大学转诊医院结核病/艾滋病合并感染患者的成功结核病治疗结果及其相关因素:一项基于机构的横断面研究。

Successful TB treatment outcome and its associated factors among TB/HIV co-infected patients attending Gondar University Referral Hospital, Northwest Ethiopia: an institution based cross-sectional study.

作者信息

Sinshaw Yenework, Alemu Shitaye, Fekadu Abel, Gizachew Mucheye

机构信息

University of Gondar referral Hospital, Gondar, Ethiopia.

Department of Epidemiology and Biostatistics, University of Gondar, Institute of Public Health, Gondar, Ethiopia.

出版信息

BMC Infect Dis. 2017 Feb 8;17(1):132. doi: 10.1186/s12879-017-2238-7.

DOI:10.1186/s12879-017-2238-7
PMID:28178936
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5299781/
Abstract

BACKGROUND

Tuberculosis/Human immunodeficiency virus (TB/HIV) co-infection is bidirectional and synergistic which mainly affects interventions that have been taken on the area. Tb patients co-infected with HIV have poorer treatment outcome as compared to non-co-infected patients. There is limited information regarding successful TB treatment outcomes and its associated factors; a reason that this study was planned to investigate.

METHODS

An institution based cross sectional study was carried out from July 2010 to January 2016. Data were abstracted from patients' medical chart using data abstraction format. The completeness of the data was checked and cleaned manually. Then, it was entered and analyzed by using SPSS version 20.0. Bi-variable and Multi-variable logistic regression model was fitted to identify factors associated with successful Tb treatment outcome. Significance was obtained through adjusted odds ratio with its 95% CI and a p < 0.05.

RESULTS

Successful TB treatment outcome among TB/HIV co-infected patients in Gondar University Hospital was 77.3% [95%CI 72.6-81.9]. Being residing in outside the Gondar town [AOR = 0.44, 95%CI: 0.25-0.80], having less than the mean baseline weight (<43.7 kg) at initiation of TB treatment [AOR = 0.51, 95% CI: 0.29-0.89], being in the bedridden condition [AOR = 0.23, 95% CI: 0.1-0.23], and experiencing anti-TB treatment side effect [AOR = 0.35, 95% CI: 0.12-0.98] were the factors that resulted the patient in treatment failure.

CONCLUSION

Successful Tb treatment outcome among TB/HIV co-infected patients was lower than the target set by Global Plan to Stop TB 2011-2015. Strengthening collaborative TB/HIV management activities that would trace the identified factors shall be recommended to increase successful treatment outcome of TB.

摘要

背景

结核病/人类免疫缺陷病毒(TB/HIV)合并感染具有双向性和协同性,这主要影响该领域已采取的干预措施。与未合并感染的患者相比,合并感染HIV的结核病患者治疗效果较差。关于成功的结核病治疗结果及其相关因素的信息有限;这就是本研究计划进行调查的原因。

方法

2010年7月至2016年1月进行了一项基于机构的横断面研究。使用数据提取格式从患者病历中提取数据。手动检查并清理数据的完整性。然后,使用SPSS 20.0版本输入并分析数据。采用双变量和多变量逻辑回归模型来确定与结核病治疗成功结果相关的因素。通过调整后的优势比及其95%置信区间和p<0.05获得显著性。

结果

贡德尔大学医院中TB/HIV合并感染患者的结核病治疗成功结果为77.3%[95%置信区间72.6 - 81.9]。居住在贡德尔镇以外[AOR = 0.44,95%置信区间:0.25 - 0.80]、结核病治疗开始时基线体重低于平均水平(<43.7千克)[AOR = 0.51,95%置信区间:0.29 - 0.89]、卧床不起[AOR = 0.23,95%置信区间:0.1 - 0.23]以及经历抗结核治疗副作用[AOR = 0.35,95%置信区间:0.12 - 0.98]是导致患者治疗失败的因素。

结论

TB/HIV合并感染患者的结核病治疗成功结果低于《2011 - 2015年全球终止结核病计划》设定的目标。建议加强协作性的TB/HIV管理活动,追踪已确定的因素,以提高结核病的治疗成功结果。

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