Mohammed Tigist, Daniel Kidist, Helamo Degefa, Leta Taye
Department of Medical Laboratory, Hossana College of Health Sciences, Hosanna, Ethiopia.
Department of Clinical Nursing, Hossana College of Health Sciences, Hosanna, Ethiopia.
Arch Public Health. 2017 Apr 3;75:16. doi: 10.1186/s13690-017-0184-x. eCollection 2017.
Tuberculosis remains to be a major public health problem among under developed world due to delay in detection and treatment of patients with active TB. In Ethiopia, tuberculosis has been recognized as a major public health problem for more than fifty years.
The main objective of this study was to determine treatment outcomes and associated factors among TB patients attending Nigist Eleni Mohammed General Hospital, Hosanna, SNNPR, Ethiopia.
A five years medical records on treatment outcomes of tuberculosis was reviewed by using a retrospective study design. A total of 768 tuberculosis patients' cards registered in TB unit register from June 2009 to August 2014 were reviewed. Data was coded, cleaned and entered into a computer data base by using EPI Info version 3.5.3 and then analysed by using Spss version 20.0 Descriptive summary values such as frequency and percentage was used to describe the study variable. Moreover, bivariate and multivariate logistic regression analysis with a confidence level of 95% was performed in order to determine the final predictors of the outcome variable. Association of age, sex, residence, HIV status of the patient and TB type/category was assessed with the TB treatment outcome through bivariate analysis. And residence, TB category and HIV status were found significantly associated with the treatment outcomes in bivariate analysis. Finally, the forward addition model was used for the multivariate analysis, and residence, TB category and HIV status of TB patient were entered into the final model to obtain an adjusted odds ratio (AOR).
Out of 768 TB patients who were registered at the hospital during the study period, 249 (32.4%) completed the treatment, 84 (10.9%) cured, 11 (1.4%) defaulted, 397 (51.7%) were transferred out to other health facility, 23 (2.9%) died and 4 (0.5%) failed the treatment regimen. In this study, the overall treatment success of TB was 333 (43.3%) as compared to their counterparts, 435 (56.7%). Patients who presented pulmonary TB + ve were more likely to develop risk of poor treatment outcomes as compared to the patients with extra pulmonary TB and pulmonary TB-ve (AOR = 1.915,95% CI;1.213,3.028). The proportion of TB HIV co-infection was16.4%, and HIV + ve TB patients were more likely to develop risk of poor treatment outcomes as compared to their counterparts (AOR = 0.796, 95% CI;0.512,1.236).
From this study, it was generally observed that the rate of defaulting was very low in the hospital. On the other hand, it was observed that the rate of transfer out of patients from the hospital to other health care facilities was very high during the study period. Furthermore, it was observed that patients who came from urban area were less likely to develop risk of poor treatment outcomes as compared to patients who reside in the rural areas.
由于活动性肺结核患者的检测和治疗延迟,结核病在欠发达国家仍然是一个主要的公共卫生问题。在埃塞俄比亚,结核病五十多年来一直被视为一个主要的公共卫生问题。
本研究的主要目的是确定在埃塞俄比亚南方民族与人民州霍桑纳的尼吉斯特·埃莱尼·穆罕默德综合医院就诊的结核病患者的治疗结果及相关因素。
采用回顾性研究设计,对五年的结核病治疗结果医疗记录进行审查。审查了2009年6月至2014年8月在结核病科室登记的768例结核病患者的病历卡。数据通过EPI Info 3.5.3版本进行编码、清理并录入计算机数据库,然后使用Spss 20.0版本进行分析。使用频率和百分比等描述性汇总值来描述研究变量。此外,进行了置信水平为95%的双变量和多变量逻辑回归分析,以确定结果变量的最终预测因素。通过双变量分析评估患者的年龄、性别、居住地、艾滋病毒感染状况和结核病类型/类别与结核病治疗结果的关联。在双变量分析中,发现居住地、结核病类别和艾滋病毒感染状况与治疗结果显著相关。最后,采用向前逐步回归模型进行多变量分析,将结核病患者的居住地、结核病类别和艾滋病毒感染状况纳入最终模型以获得调整后的比值比(AOR)。
在研究期间在该医院登记的768例结核病患者中,249例(32.4%)完成治疗,84例(10.9%)治愈,11例(1.4%)失访,397例(51.7%)转至其他医疗机构,23例(2.9%)死亡,4例(0.5%)治疗方案失败。在本研究中,结核病的总体治疗成功率为333例(43.3%),而其他患者为435例(56.7%)。与肺外结核和肺结核阴性患者相比,肺结核阳性患者更有可能出现治疗效果不佳的风险(AOR = 1.915,95%CI;1.213,3.028)。结核病合并艾滋病毒感染的比例为16.4%,与艾滋病毒阴性的结核病患者相比,艾滋病毒阳性的结核病患者更有可能出现治疗效果不佳的风险(AOR = 0.796,95%CI;0.512,1.236)。
从本研究中总体观察到,该医院的失访率非常低。另一方面,在研究期间观察到,从该医院转至其他医疗机构的患者比例非常高。此外,观察到与居住在农村地区的患者相比,来自城市地区的患者出现治疗效果不佳风险的可能性较小。