Mazza-Stalder Jesica, Chevallier Emilie, Opota Onya, Carreira Ana, Jaton Katia, Masserey Eric, Zellweger Jean Pierre, Nicod Laurent Pierre
Pulmonary Division, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
Vaud Lung Association, Lausanne, Switzerland.
Front Med (Lausanne). 2019 Jun 21;6:135. doi: 10.3389/fmed.2019.00135. eCollection 2019.
Studies performed locally in Switzerland in the late eighties reported unsatisfactory treatment outcomes. Better outcomes were observed since the introduction of directly observed therapy (DOT) in the late nineties and improvement in social support in recent years. retrospective study of treatment outcomes for all tuberculosis (TB) patients notified in Vaud County (VD), Switzerland, between, 1st of January 2010 and 31st of December of 2014. 375 patients were notified in VD during the study period. The global outcome was successful in 90.1% of patients (338/375). In 183 culture and PCR positive pulmonary TB, the documented cure rate was 57.9% (106/183), and the treatment completion was 59/183 (32.2%), i.e., a treatment success of 90.2%. DOT was applied globally in 234/375 (62.4%) and in 64/67 of the asylum seekers (AS) (95.5%) followed at the dispensary. Treatment outcomes were successful in 60/67 (89.6%) AS. Improvements in tuberculosis outcomes resulted not only from the introduction of DOT in VD in the nineties but also from a change in the management, with increased attention to the social problems faced by the migrants. A combined medical and social approach of TB care in VD improved treatment outcomes.
瑞士在八十年代后期开展的本地研究报告了不尽人意的治疗结果。自九十年代后期引入直接观察治疗法(DOT)以及近年来社会支持得到改善以来,观察到了更好的结果。对2010年1月1日至2014年12月31日期间瑞士沃州(VD)通报的所有结核病患者的治疗结果进行了回顾性研究。在研究期间,VD共通报了375例患者。总体结果显示90.1%的患者(338/375)治疗成功。在183例培养和PCR检测呈阳性的肺结核患者中,记录的治愈率为57.9%(106/183),完成治疗的有59/183例(32.2%),即治疗成功率为90.2%。DOT在375例患者中的234例(62.4%)中普遍应用,在药房随访的67例寻求庇护者(AS)中有64例(95.5%)应用。67例AS患者中有60例(89.6%)治疗成功。结核病治疗结果的改善不仅源于九十年代在VD引入DOT,还源于管理方式的改变,对移民面临的社会问题给予了更多关注。VD采用的医疗与社会相结合的结核病护理方法改善了治疗结果。