Atekem Kareen A, Tanih Nicoline Fri, Ndip Roland Ndip, Ndip Lucy Mande
Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Banjul, The Gambia.
Laboratory Services Department, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.
Int J Mycobacteriol. 2018 Apr-Jun;7(2):137-142. doi: 10.4103/ijmy.ijmy_20_18.
Tuberculosis (TB) has been ranked as one of the leading causes of death worldwide. In Cameroon, the National Tuberculosis Control Program aims to fight TB through the implementation of international directives (Directly Observed Treatment Short course [DOTS]). TB control program must reach global targets for detection (70%) and treatment success (85%) as stated by the United Nations Millennium Development Goals (MDGs). Implementing DOTS in Cameroon has not met the MDGs of 85% success rate. This study aimed at identifying factors affecting treatment success.
A cross-sectional retrospective study was used to collect data from 895 TB registers from January 2011 to December 2012. Out of the seven treatment centers in Fako Division, three were randomly selected following stratification into government, not-for-profit and for-profit structures. Descriptive statistics were used to obtain frequencies. Binomial logistics regression was used to obtain significant values for the various factors. Multinomial logistics was used on significant factors.
Of the 895 registered TB patient records obtained, 416 (46.5%) patient were female and 479 (53.5%) patient were male. Characterizing TB patients, 510 (57.0%) were smear-positive pulmonary TB, 225 (25.1%) were smear-negative pulmonary TB, and 160 (17.9%) were extrapulmonary TB patients. Comparing treatment success rate (TSR) across the three centers, Baptist Hospital Mutengene had the highest value 94.97 (38%), followed by Regional Hospital Buea 83.74 (33%), and Central Clinic Tiko the least 73.13 (29%).
Patient registration year, treatment center, TB classification, and HIV status were identified to significantly affect TSR, hence, effectiveness of the TB program.
结核病一直是全球主要死因之一。在喀麦隆，国家结核病控制规划旨在通过实施国际指令（直接观察短程化疗[DOTS]）来抗击结核病。结核病控制规划必须实现联合国千年发展目标（MDGs）规定的全球检测目标（70%）和治疗成功率目标（85%）。在喀麦隆实施DOTS尚未达到MDGs规定的85%成功率目标。本研究旨在确定影响治疗成功的因素。
采用横断面回顾性研究，从2011年1月至2012年12月的895份结核病登记册中收集数据。在法科省的七个治疗中心中，按照政府、非营利和营利结构分层后随机选择三个。使用描述性统计获取频率。使用二项逻辑回归获取各种因素的显著值。对显著因素使用多项逻辑回归。
在获得的895份已登记结核病患者记录中，416例（46.5%）患者为女性，479例（53.5%）患者为男性。结核病患者特征为，510例（57.0%）为涂片阳性肺结核，225例（25.1%）为涂片阴性肺结核，160例（17.9%）为肺外结核患者。比较三个中心的治疗成功率（TSR），穆滕盖内浸信会医院最高，为94.97（38%），其次是布埃亚地区医院，为83.74（33%），蒂科中央诊所最低，为73.13（29%）。
确定患者登记年份、治疗中心、结核病分类和艾滋病毒状况对TSR有显著影响，因此对结核病规划的有效性有显著影响。
