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儿童结核病:埃塞俄比亚西北部儿童的管理与治疗结果:一项横断面研究

Childhood tuberculosis: management and treatment outcomes among children in Northwest Ethiopia: a cross-sectional study.

作者信息

Kebede Zemene Tigabu, Taye Belaynew Wasie, Matebe Yohannes Hailu

机构信息

Department of Paediatrics, College of Medicine, University of Gondar, Ethiopia.

School of Public Health, College of Medicine, Bahir Dar University, Ethiopia.

出版信息

Pan Afr Med J. 2017 May 10;27:25. doi: 10.11604/pamj.2017.27.25.10120. eCollection 2017.

Abstract

INTRODUCTION

Childhood tuberculosis (TB) treatment is becoming a major challenge in the TB control efforts of the Ethiopian health system. This study assessed childhood tuberculosis management, and treatment outcomes among children who completed anti-TB treatment in Northwest Ethiopia.

METHODS

A cross-sectional study was conducted among children who completed their anti-TB treatment in Gondar University Referral Hospital and 6 satellite health centers. Data from each child with tuberculosis were obtained from review of medical records. P-values < 0.05 were considered statistically significant.

RESULTS

The commonest method of childhood TB diagnosis was clinical assessment combined with chest x-ray (48.5%). Absence of compliance with TB treatment guideline (98.7%), providing inadequate anti-TB regimen (1.8%), and poor adherence to treatment (22.5%) were challenges in management of childhood tuberculosis. Treatment success rate was 78.9%. In the bivariate regression, factors associated with TB treatment outcomes were permanent residence (OR=8.3, 95%CI: 4.1, 16.7), antiretroviral therapy (OR=4.5, 95%CI: 1.2, 16), and adherence to treatment (p < 0.001). After controlling for confounders, adherence to anti-TB treatment (OR=0.003, 95% CI: 0.001, 0.02) was independent predictor of treatment success.

CONCLUSION

Anti-tuberculosis treatment success rate was still low among children in Northwest Ethiopia. The health centers and hospital shall enhance strong follow-up of children on anti-tuberculosis treatment to improve treatment success with focus on rural children.

摘要

引言

儿童结核病治疗正成为埃塞俄比亚卫生系统结核病控制工作中的一项重大挑战。本研究评估了埃塞俄比亚西北部完成抗结核治疗的儿童的结核病管理及治疗结果。

方法

在贡德尔大学转诊医院和6个卫星卫生中心对完成抗结核治疗的儿童进行了一项横断面研究。通过查阅病历获取每个结核病儿童的数据。P值<0.05被认为具有统计学意义。

结果

儿童结核病最常见的诊断方法是临床评估结合胸部X光检查(48.5%)。儿童结核病管理面临的挑战包括未遵守结核病治疗指南(98.7%)、抗结核治疗方案不足(1.8%)以及治疗依从性差(22.5%)。治疗成功率为78.9%。在双变量回归中,与结核病治疗结果相关因素为常住地(比值比=8.3,95%置信区间:4.1,16.7)、抗逆转录病毒疗法(比值比=4.5,95%置信区间:1.2,16)和治疗依从性(p<0.001)。在控制混杂因素后,抗结核治疗依从性(比值比=0.003,95%置信区间:0.001,0.02)是治疗成功的独立预测因素。

结论

埃塞俄比亚西北部儿童的抗结核治疗成功率仍然较低。卫生中心和医院应加强对接受抗结核治疗儿童的密切随访,以提高治疗成功率,重点关注农村儿童。

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