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坦桑尼亚耐多药结核病患者死亡率的预测因素

Predictors for Mortality among Multidrug-Resistant Tuberculosis Patients in Tanzania.

作者信息

Mollel Edson W, Chilongola Jaffu O

机构信息

Kibong'oto Infectious Diseases Hospital, P.O. Box 12, Sanya Juu, Siha, Tanzania.

Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania.

出版信息

J Trop Med. 2017;2017:9241238. doi: 10.1155/2017/9241238. Epub 2017 Jul 20.

Abstract

PROBLEM

Factors related to MDRTB mortality in Tanzania have not been adequately explored and reported.

OBJECTIVES

To determine demographic, clinical, radiographic, and laboratory factors associated with MDRTB mortality in a Tanzanian TB Referral Hospital.

METHODOLOGY

This was a cross-sectional study with 193 participants. Demographic, clinical, laboratory, and radiological data were collected, and their associations with mortality among MDRTB patients were determined.

RESULTS AND CONCLUSIONS

Cough was the commonest finding among these MDRTB patients, with 179 (92.75%) of them presenting with cough, followed by chest X-ray consolidation in 156 patients (80.83%) and history of previous TB treatment in 151 patients (78.24%). Cigarette smoking, HIV positivity, and low CD4 counts were significantly associated with MDRTB mortality, values of 0.034, 0.044, and 0.048, respectively. Fever on the other hand was at the borderline with value of 0.059. We conclude that cigarette smoking and HIV status are significant risk factors for mortality among MDRTB patients. HIV screening should continually be emphasized among patients and the general community for early ARTs initiation. Based on the results from our study, policy makers and public health personnel should consider addressing tobacco cessation as part of national TB control strategy.

摘要

问题

坦桑尼亚耐多药结核病(MDRTB)死亡相关因素尚未得到充分探究和报道。

目的

确定坦桑尼亚一家结核病转诊医院中与耐多药结核病死亡相关的人口统计学、临床、影像学和实验室因素。

方法

这是一项针对193名参与者的横断面研究。收集了人口统计学、临床、实验室和放射学数据,并确定了它们与耐多药结核病患者死亡率之间的关联。

结果与结论

咳嗽是这些耐多药结核病患者中最常见的症状,其中179人(92.75%)出现咳嗽,其次是156名患者(80.83%)有胸部X线实变,151名患者(78.24%)有既往结核病治疗史。吸烟、HIV阳性和低CD4计数与耐多药结核病死亡率显著相关,P值分别为0.034、0.044和0.048。另一方面,发热处于临界值,P值为0.059。我们得出结论,吸烟和HIV状态是耐多药结核病患者死亡的重要危险因素。应持续在患者和普通人群中强调HIV筛查,以便尽早开始抗逆转录病毒治疗(ARTs)。基于我们的研究结果,政策制定者和公共卫生人员应考虑将戒烟作为国家结核病控制策略的一部分加以解决。

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