Abebe Gemeda, Bonsa Zegeye, Kebede Wakjira
Department of Medical Laboratory Science, Institute of Health; Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia.
Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia.
Int J Mycobacteriol. 2019 Jan-Mar;8(1):35-41. doi: 10.4103/ijmy.ijmy_177_18.
Monitoring the outcome of tuberculosis (TB) treatment and investigating factors associated with unsuccessful outcome are essential, as unsuccessful treatment fuels resistance to antibiotics. This study aimed to investigate the treatment outcome and associated factors with an unsuccessful outcome at Jimma University Medical Center (JUMC), Southwest Ethiopia.
A 5-year retrospective analytical study, including all types of TB cases who sought care at JUMC between September 1, 2012, and August 31, 2017, was conducted. Treatment outcomes and TB types were categorized according to the National TB Control guideline. Bivariate analysis was used to analyze the association between treatment outcome and potential variables.
Overall data from 1249 patients' records were included in the study. The proportion of male patients was higher (815, 65.3%) than that of females. The mean age (± standard deviation, range) of the cases was 26 (±11. 6, 1-71) years. Of the total, 292 (23.3%) were smear-positive pulmonary TB (PTB), 489 (39.2%) smear-negative PTB, and 468 (37.5%) extra-PTB (EPTB) cases. Available treatment outcomes indicate that 253 (20.2%) were cured, 850 (68.0%) completed therapy, 58 (4.8%) died, 83 (6.6%) defaulted, and 5 (0.4%) failed the therapy. About 76 (5.6%) cases were transferred out and 44 (3.2%) cases were lost to follow-up. In total, 146 (11.7%) patients had an unsuccessful outcome. Unsuccessful treatment outcome was associated with smear-negative PTB (odds ratio [OR] =2.0, 95% confidence intervals [CI] =1.1, 3.7), EPTB (OR = 2.1, 95% CI = 1.2, 3.4), and unknown human immunodeficiency virus (HIV) status (OR = 7.9, 95% CI = 2.5, 25.0).
The treatment success rate of overall TB patients is lower than end TB Strategy target of ≥90% success rate. Smear-negative PTB, EPTB cases, and those with unknown HIV status tend to have unsuccessful outcome.
监测结核病（TB）治疗结果并调查与治疗失败相关的因素至关重要，因为治疗失败会加剧对抗生素的耐药性。本研究旨在调查埃塞俄比亚西南部吉马大学医学中心（JUMC）的治疗结果及与治疗失败相关的因素。
开展了一项为期5年的回顾性分析研究，纳入了2012年9月1日至2017年8月31日期间在JUMC就诊的所有类型结核病病例。治疗结果和结核病类型根据国家结核病控制指南进行分类。采用双变量分析来分析治疗结果与潜在变量之间的关联。
该研究纳入了1249例患者记录的总体数据。男性患者比例（815例，65.3%）高于女性。病例的平均年龄（±标准差，范围）为26（±11.6，1 - 71）岁。其中，292例（23.3%）为涂片阳性肺结核（PTB），489例（39.2%）为涂片阴性PTB，468例（37.5%）为肺外结核（EPTB）病例。可得的治疗结果表明，253例（20.2%）治愈，850例（68.0%）完成治疗，58例（4.8%）死亡，83例（6.6%）中断治疗，5例（0.4%）治疗失败。约76例（5.6%）病例转出，44例（3.2%）病例失访。总计146例（11.7%）患者治疗失败。治疗失败与涂片阴性PTB（比值比[OR]=2.0，95%置信区间[CI]=1.1，3.7）、EPTB（OR = 2.1，95% CI = 1.2，3.4）以及人类免疫缺陷病毒（HIV）状态未知（OR = 7.9，95% CI = 2.5，25.0）相关。
总体结核病患者的治疗成功率低于终结结核病战略目标的≥90%成功率。涂片阴性PTB、EPTB病例以及HIV状态未知的患者往往治疗失败。
