喀麦隆滨海地区经项目条件下咨询和治疗的菌阴肺外结核患者及治疗结局。
Bacteriologically confirmed extra pulmonary tuberculosis and treatment outcome of patients consulted and treated under program conditions in the littoral region of Cameroon.
机构信息
Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon.
Tuberculosis Reference Laboratory, Douala, Littoral Region, Cameroon.
出版信息
BMC Pulm Med. 2019 Jan 17;19(1):17. doi: 10.1186/s12890-018-0770-x.
BACKGROUND
Extra-pulmonary tuberculosis (EPTB) is defined as any bacteriologically confirmed or clinically diagnosed case of TB involving organs other than the lungs. It is frequently a diagnostic and therapeutic challenge with paucity of data available. The aim of this study was to assess the prevalence of bacteriologically confirmed EPTB; to determine the most affected organs and to evaluate the therapeutic outcome of EPTB patients treated under program conditions in the littoral region of Cameroon.
METHODS
A descriptive cross-sectional laboratory-based epidemiological survey was conducted from January 2016 to December 2017 and 109 specimens from 15 of the 39 diagnosis and treatment centers in the littoral region were obtained. Two diagnostic methods (Gene Xpert MTB and culture (LJ and MGIT) were used for EPTB diagnosis. Determine HIV1/2 and SD Biolinewere used for HIV diagnosis. Confirmed EPTB cases were treated following the national tuberculosis guide.
RESULTS
The prevalence of bacteriologically confirmed EPTB was 41.3% (45). All 45 cases were sensitive to rifampicin. Males were predominately more infected [26 (57.8%)] likewise the age group 31-45 years with 15 (33.3%) cases. The overall prevalence for HIV was 33.6% (36). HIV infection was present in 28.9% (13) of patients with EPTB. The most affected sites with EPTB were: Lymph nodes (66.5%), pleural cavity (15.6%), abdominal organs (11.1%), neuromeningeal (2.2%), joints (2.2%) and heart (2.2%). Overall, 84.4% of the study participants had a therapeutic success with males responding better 57.9% (p = 0.442). Therapeutic success was better (71.7%) in HIV negative EPTB patients (p = 0.787).
CONCLUSION
The prevalence of bacteriologically confirmed EPTB patients treated under program conditions in the littoral region of Cameroon is high with a therapeutic success of 84.4% and the lymph nodes is the most affected site.
背景
肺外结核（EPTB）定义为任何经细菌学证实或临床诊断的累及肺部以外器官的结核病。由于缺乏相关数据，EPTB 通常是一个诊断和治疗方面的挑战。本研究旨在评估在喀麦隆滨海地区经方案治疗的细菌学确诊 EPTB 的患病率；确定最易受影响的器官；并评估 EPTB 患者的治疗效果。
方法
这是一项描述性的横断面实验室流行病学调查，于 2016 年 1 月至 2017 年 12 月进行，从滨海地区的 39 个诊断和治疗中心中选取了 15 个中心的 109 份标本。采用 Gene Xpert MTB 和培养（LJ 和 MGIT）两种方法进行 EPTB 诊断。使用 Determine HIV1/2 和 SD Bioline 进行 HIV 诊断。确诊的 EPTB 病例按照国家结核病指南进行治疗。
结果
经细菌学确诊的 EPTB 患病率为 41.3%（45 例）。所有 45 例病例均对利福平敏感。男性感染比例较高[26 例（57.8%）]，年龄组为 31-45 岁，有 15 例（33.3%）病例。HIV 总感染率为 33.6%（36 例）。HIV 感染存在于 28.9%（13 例）的 EPTB 患者中。EPTB 最常累及的部位是：淋巴结（66.5%）、胸腔（15.6%）、腹部器官（11.1%）、神经脑膜（2.2%）、关节（2.2%）和心脏（2.2%）。总的来说，84.4%的研究参与者的治疗效果良好，男性的治疗效果更好，为 57.9%（p=0.442）。HIV 阴性的 EPTB 患者的治疗效果更好（71.7%）（p=0.787）。
结论
在喀麦隆滨海地区，经方案治疗的细菌学确诊 EPTB 患者的患病率较高，治疗成功率为 84.4%，最常累及的部位是淋巴结。
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