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埃塞俄比亚西南部HIV感染患者的结核病治疗结局及其预测因素

Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia.

作者信息

Teshome Kefale Adane, Anagaw Yeniewa Kerie

机构信息

Department of Pharmacy, College of Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia.

出版信息

Int J Gen Med. 2017 Jun 6;10:161-169. doi: 10.2147/IJGM.S135305. eCollection 2017.

Abstract

BACKGROUND

Co-infection with HIV challenges treatment of tuberculosis (TB) and worsens the outcome. This study aimed to assess the outcome of TB treatment and its predictors among HIV infected patients at Mizan-Tepi University Teaching Hospital (MTUTH), Ethiopia.

METHODS

Medical records of 188 TB/HIV co-infected patients who attended the TB clinic of MTUTH from September 2012 to December 2015 were reviewed from March 14 to April 1, 2016. The primary endpoints of the study were treatment outcome of TB and its predictors. Data were analyzed by Statistical Package for Social Sciences version 21. Multivariable binary logistic regression analysis was carried out to identify predictors of treatment outcome. Statistical significance was considered at -value <0.05.

RESULT

The treatment outcomes of TB patients included in this study were 18 (9.57%) cured, 20 (10.64%) defaulted, 24 (12.77%) died, 39 (20.74%) completed the treatment, and 87 (46.28%) transferred out. A successful treatment outcome was achieved in 57 (30.32%) patients. Initial World Health Organization (WHO) clinical stage III (COR: 2.60; 95%CI: 1.17-5.76) and stage IV (COR: 4.00; 95%CI: 1.29-12.40) were associated with unfavorable outcome. Both WHO stages (III, IV) at the time of HIV diagnosis were independent predictors of poor treatment outcome (AOR: 3.08; 95%CI: 1.14-8.38; AOR: 5.80; 95%CI: 1.36-24.71 respectively). However, smear positive TB was an independent predictor of a favorable treatment outcome (AOR: 2.50; 95%CI: 1.13-5.51).

CONCLUSION

This study revealed that treatment outcome of TB patients was unsatisfactory, which signals a need for improved care. Advanced WHO clinical stages were predictors of poor outcome, while smear positive TB favors good outcome.

摘要

背景

合并感染艾滋病毒给结核病(TB)的治疗带来挑战,并使治疗结果恶化。本研究旨在评估埃塞俄比亚米赞-泰皮大学教学医院(MTUTH)艾滋病毒感染患者的结核病治疗结果及其预测因素。

方法

2016年3月14日至4月1日,回顾了2012年9月至2015年12月在MTUTH结核病门诊就诊的188例结核病/艾滋病毒合并感染患者的病历。该研究的主要终点是结核病的治疗结果及其预测因素。数据采用社会科学统计软件包第21版进行分析。进行多变量二元逻辑回归分析以确定治疗结果的预测因素。P值<0.05时认为具有统计学意义。

结果

本研究纳入的结核病患者的治疗结果为18例(9.57%)治愈,20例(10.64%)中断治疗,24例(12.77%)死亡,39例(20.74%)完成治疗,87例(46.28%)转出。57例(30.32%)患者获得了成功的治疗结果。世界卫生组织(WHO)初始临床分期III期(校正比值比:2.60;95%置信区间:1.17 - 5.76)和IV期(校正比值比:4.00;95%置信区间:1.29 - 12.40)与不良治疗结果相关。艾滋病毒诊断时的WHO分期(III期、IV期)均是治疗结果不佳的独立预测因素(调整后比值比分别为:3.08;95%置信区间:1.14 - 8.38;5.80;95%置信区间:1.36 - 24.71)。然而,涂片阳性结核病是治疗结果良好的独立预测因素(调整后比值比:2.50;95%置信区间:1.13 - 5.51)。

结论

本研究表明结核病患者的治疗结果不尽人意,这表明需要改善护理。WHO临床分期较高是不良治疗结果的预测因素,而涂片阳性结核病有利于良好的治疗结果。

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Tuberculosis and HIV co-infection.结核病和艾滋病病毒合并感染。
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