青少年和青年人群中的结核病：西开普省的流行病学及治疗结果

Tuberculosis in adolescents and young adults: epidemiology and treatment outcomes in the Western Cape.

作者信息

Snow K, Hesseling A C, Naidoo P, Graham S M, Denholm J, du Preez K

机构信息

Centre for International Child Health, University of Melbourne, Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

出版信息

Int J Tuberc Lung Dis. 2017 Jun 1;21(6):651-657. doi: 10.5588/ijtld.16.0866.

DOI:10.5588/ijtld.16.0866

PMID:28482959

Abstract

SETTING

Western Cape Province, South Africa.

OBJECTIVES

To characterise tuberculosis (TB) epidemiology, disease presentation and treatment outcomes among adolescents (age 10-19 years) and young adults (age 20-24 years) in the Western Cape.

DESIGN

A retrospective, cross-sectional review of routine patient-level data from the Electronic TB Register (ETR.Net) for 2013. Site of TB disease, human immunodeficiency virus (HIV) status and TB treatment outcomes were analysed by 5-year age groups (<5, 5-9, 10-14, 15-19, 20-24 and 25 years of age). TB notification rates were calculated using census data.

RESULTS

Adolescents and young adults comprised 18.0% of all new TB notifications in 2013. The notification rate was 141 TB cases/100 000 person-years (py) among 10-14 year olds, 418/100 000 py among 15-19 year olds and 627/100 000 py among 20-24 year olds. HIV prevalence among TB patients was 10.9% in 10-14 year olds, 8.8% in 15-19 year olds and 27.2% in 20-24 year olds. Older adolescents (age 15-19 years) and young adults (age 20-24 years) with HIV co-infection had poor treatment outcomes: 15.6% discontinued treatment prematurely and 4.0% died.

CONCLUSIONS

Young people in the Western Cape suffer a substantial burden of TB, and those with TB-HIV co-infection are at high risk of treatment discontinuation.

摘要

背景

南非西开普省。

目的

描述西开普省青少年（10 - 19岁）和青年（20 - 24岁）结核病（TB）的流行病学特征、疾病表现及治疗结果。

设计

对2013年电子结核病登记册（ETR.Net）中常规患者层面数据进行回顾性横断面分析。按5岁年龄组（<5岁、5 - 9岁、10 - 14岁、15 - 19岁、20 - 24岁及≥25岁）分析结核病发病部位、人类免疫缺陷病毒（HIV）感染状况及结核病治疗结果。使用人口普查数据计算结核病报告率。

结果

2013年青少年和青年占所有新结核病报告病例的18.0%。10 - 14岁年龄组的报告率为每10万人年141例结核病病例，15 - 19岁年龄组为每10万人年418例，20 - 24岁年龄组为每10万人年627例。结核病患者中的HIV感染率在10 - 14岁年龄组为10.9%，15 - 19岁年龄组为8.8%，20 - 24岁年龄组为27.2%。合并感染HIV的大龄青少年（15 - 19岁）和青年（20 - 24岁）治疗效果不佳：15.6%过早停止治疗，4.0%死亡。