Tetteh Ato Kwamena, Agyarko Edward, Otchere Joseph, Bimi Langbong, Ayi Irene
Laboratory Department, Metropolitan Hospital, P.O. Box 174, Cape Coast, Ghana.
Department of Community Medicine and Health, Anglican University College of Technology, P.O. Box 74, Nkoranza, Ghana.
Tuberc Res Treat. 2018 Feb 15;2018:4287842. doi: 10.1155/2018/4287842. eCollection 2018.
We present, for the first time, an evaluation of treatment outcomes in a cohort at a TB referral centre in the Central Region of Ghana. Of the 213 clients placed on DOTS, 59.2% (126/213) were sputum smear-positive. An overall cure rate of 90.2% (51.6% cured + 37.6% completed) and a death rate of 8.5% (18/213) were estimated. Of the number of clients who died, 5.7% (12/213) were males ( = 2.891, = 0.699; LR = 3.004, = 0.699). Deaths were only recorded among clients who were > 19 years old ( = 40.319, = 0.099; LR = 41.244, = 0.083). Also, 0.9% (2/213) was lost to follow-up, while 1.4% (3/213) had treatment failure. In total, 13.6% (7.0%, 15/213 males, and 6.6%, 14/213 females) of clients who were placed on DOTS were HIV seropositive. Ages of 40-49 years had the highest number, 13/213 (6.1%), infected with HIV, though the difference among the remaining age groups was not statistically significant ( = 9.621, = 0.142). Furthermore, 7.0% (15/213) had TB/HIV coinfection. Out of them, 9 were cured and 5 died at home, while 1 had treatment failure. Tuberculosis/HIV infection prevention advocacy and interventions that address sociodemographic determinants of unfavourable treatment outcomes are urgently required to augment national efforts towards control.
我们首次对加纳中部地区一家结核病转诊中心队列的治疗结果进行了评估。在接受直接观察治疗短程化疗（DOTS）的213名患者中，59.2%（126/213）痰涂片呈阳性。估计总体治愈率为90.2%（治愈51.6% + 完成治疗37.6%），死亡率为8.5%（18/213）。在死亡患者中，5.7%（12/213）为男性（χ² = 2.891，P = 0.699；似然比（LR） = 3.004，P = 0.699）。仅在年龄大于19岁的患者中记录到死亡情况（χ² = 40.319，P = 0.099；LR = 41.244，P = 0.083）。此外，0.9%（2/213）失访，1.4%（3/213）治疗失败。接受DOTS治疗的患者中，总计13.6%（男性7.0%，15/213；女性6.6%，14/213）HIV血清学呈阳性。40 - 49岁年龄组感染HIV的人数最多，为13/213（6.1%），不过其余年龄组之间的差异无统计学意义（χ² = 9.621，P = 0.142）。此外，7.0%（15/213）患有结核病/艾滋病合并感染。其中，9例治愈，5例在家中死亡，1例治疗失败。迫切需要开展结核病/艾滋病感染预防宣传及干预措施，以解决导致不良治疗结果的社会人口学决定因素，从而加强国家的防控努力。
