Diaw Mama Moussa, Ndiaye Mamoudou, Riccardi Niccolò, Ungaro Riccardo, Alagna Riccardo, Cirillo Daniela Maria, Codecasa Luigi, Viscoli Claudio, Nicolini Laura Ambra, Besozzi Giorgio
Médecin coordonnateur lutte contre la TB, Région médicale de Thiès, Thiès, Sénégal.
Bureau Régional Immunisation et Surveillance Epidemiologique de Thiès, Avenue Malick SY prolongée BP 34A, Thiès, RP Sénégal.
Multidiscip Respir Med. 2018 Nov 9;13:41. doi: 10.1186/s40248-018-0154-3. eCollection 2018.
Since 2013 StopTB Italia Onlus supports the Senegalese National Tuberculosis Programme by improving diagnostic capability with technological interventions, ameliorating educational programs for health care personnel, rising awareness among civil society and providing economical support for patients during treatment. The purpose of our study was to assess the preliminary results of an interventional cooperation project in a peripheral health care facility in Senegal.
An observational, retrospective, pre-post study was conducted to compare Tuberculosis (TB) retention in care and outcome between a one-year period before and a four-year period after.
Overall, 239 patients with active TB were included, 196 (82%) of whom after the starting of the collaboration project. At diagnosis 35/43(81.4%) vs 151/196 (77%) patients were smear sputum positive before and after the beginning of the project, respectively.At 2 months follow up 23/35 (65.7%) patients in 2012 vs. 139/151 (92%) patients in 2013-2016 had negative control AFB stain ( = 0.249), 4/35 (11.4%) vs 12/151 (8%) patients remained AFB stain positive ( = 0.17), 7/35 (20%) vs 0/151 died before the 2 months follow up ( < 0.0001). TB treatment outcome was more frequently favourable after the beginning of cooperation 29/43 (67.4%) vs. 176/196 (89.8%) patients, ( 0.0001). Patients' mortality during treatment decreased from 8/43 (18.6%) in 2012 to 11/196 (5.6%) patients in the following years ( = 0.009).
The implementation of diagnostic procedures, if integrated in a socio-economical intervention, impacts favourably on TB retention in care and treatment outcomes.
自2013年以来，意大利抗击结核病非营利组织通过技术干预提高诊断能力、改善医护人员教育项目、提高民间社会的认识并在患者治疗期间提供经济支持，来支持塞内加尔国家结核病防治规划。我们研究的目的是评估在塞内加尔一家基层医疗机构开展的一项干预合作项目的初步结果。
开展一项观察性、回顾性、前后对照研究，比较一年期之前和四年期之后结核病的治疗依从性和治疗结果。
总体上，纳入了239例活动性结核病患者，其中196例（82%）是在合作项目启动之后。诊断时，项目开始前和开始后痰涂片阳性患者分别为35/43（81.4%）和151/196（77%）。在2个月随访时，2012年23/35（65.7%）例患者与2013 - 2016年139/151（92%）例患者的抗酸杆菌染色阴性（P = 0.249），4/35（11.4%）例患者与12/151（8%）例患者抗酸杆菌染色仍为阳性（P = 0.17），7/35（20%）例患者与0/151例患者在2个月随访前死亡（P < 0.0001）。合作开始后结核病治疗结果更常为良好，分别为29/43（67.4%）例患者与176/196（89.8%）例患者（P < 0.0001）。治疗期间患者死亡率从2012年的8/43（18.6%）降至随后几年的11/196（5.6%）例患者（P = 0.009）。
如果将诊断程序纳入社会经济干预中，其实施会对结核病的治疗依从性和治疗结果产生有利影响。
