School of Laboratory Medicine, Wannan Medical College, 22 West Wenchang Road, Wuhu, Anhui Province, 241002, People's Republic of China.
Tuberculosis Prevention and Control Department, Anqing Center for Disease Control and Prevention, Anqing City, Anhui Province, 246003, People's Republic of China.
BMC Infect Dis. 2018 Mar 5;18(1):104. doi: 10.1186/s12879-018-3019-7.
Monitoring the treatment outcomes of tuberculosis and determining the specific factors associated with unsuccessful treatment outcome are essential to evaluate the effectiveness of tuberculosis control program. This study aimed to assess treatment outcomes and explore the factors associated with unsuccessful outcomes among new pulmonary smear positive and negative tuberculosis patients in Anqing, China.
A nine-year retrospective study was conducted using data from Anqing Center for Diseases Prevention and Control. New pulmonary tuberculosis patients treated with two six-month regimens were investigated. Non-conditional logistic regression was performed to calculate odds ratios and 95% confidence intervals for factors associated with unsuccessful outcomes.
Among 22,998 registered patients (16,939 males, 6059 females), 64.54% were smear-positive patients. The treatment success rates was 95.02% for smear-positive patients and 95.00% for smear-negative patients. Characteristics associated with an higher risk of unsuccessful treatment among smear-positive patients included aged above 35 years, treatment management model of self-medication, full-course management and supervision in intensive phase, unchecked chest X-ray, cavity in chest X-ray, and miliary shadow in chest X-ray, while normal X-ray was negative factor. Unsuccessful treatment among smear-negative patients was significantly associated with age over 45 years, treatment management model of full-course management, unchecked chest X-ray, presence of miliary shadow in chest X-ray and delay over 51 days.
Tuberculosis treatment in Anqing area was successful and independent of treatment regimens. Special efforts are required for patients with unsuccessful outcomes.
监测结核病的治疗结果，并确定与治疗结果不佳相关的具体因素，对于评估结核病控制规划的效果至关重要。本研究旨在评估安庆市新涂阳和新涂阴肺结核患者的治疗结局，并探讨与治疗结局不佳相关的因素。
使用安庆市疾病预防控制中心的数据，进行了一项为期九年的回顾性研究。对接受两阶段六个月方案治疗的新肺结核患者进行了调查。采用非条件逻辑回归计算与治疗结局不佳相关因素的比值比和 95%置信区间。
在 22998 名登记患者中（男性 16939 名，女性 6059 名），64.54%为涂阳患者。涂阳患者的治疗成功率为 95.02%，涂阴患者为 95.00%。涂阳患者中，年龄大于 35 岁、自服药治疗管理模式、全程管理和强化期监督、未检查胸部 X 光、胸部 X 光有空洞、胸部 X 光有粟粒影与治疗结局不佳风险较高相关，而 X 光正常为负相关因素。涂阴患者中，年龄大于 45 岁、全程管理治疗管理模式、未检查胸部 X 光、胸部 X 光有粟粒影和延迟超过 51 天与治疗结局不佳显著相关。
安庆地区的结核病治疗是成功的，且与治疗方案无关。需要对治疗结局不佳的患者给予特别关注。
