Department of Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil.
Department of Medicine, Nueva Granada Military University, Bogotá, D.C., Colombia.
PLoS One. 2019 Dec 27;14(12):e0226507. doi: 10.1371/journal.pone.0226507. eCollection 2019.
To produce pooled estimates of the global results of tuberculosis (TB) treatment and analyze the predictive factors of successful TB treatment.
Studies published between 2014 and 2019 that reported the results of the treatment of pulmonary TB and the factors that influenced these results. The quality of the studies was evaluated according to the Newcastle-Ottawa quality assessment scale. A random effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (CI). This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) in February 2019 under number CRD42019121512.
A total of 151 studies met the criteria for inclusion in this review. The success rate for the treatment of drug-sensitive TB in adults was 80.1% (95% CI: 78.4-81.7). America had the lowest treatment success rate, 75.9% (95% CI: 73.8-77.9), and Oceania had the highest, 83.9% (95% CI: 75.2-91.0). In children, the success rate was 84.8% (95% CI: 77.7-90.7); in patients coinfected with HIV, it was 71.0% (95% CI: 63.7-77.8), in patients with multidrug-resistant TB, it was 58.4% (95% CI: 51.4-64.6), in patients with and extensively drug-resistant TB it was 27.1% (12.7-44.5). Patients with negative sputum smears two months after treatment were almost three times more likely to be successfully treated (OR 2.7; 1.5-4.8), whereas patients younger than 65 years (OR 2.0; 1.7-2.4), nondrinkers (OR 2.0; 1.6-2.4) and HIV-negative patients (OR 1.9; 1.6-2.5 3) were two times more likely to be successfully treated.
The success of TB treatment at the global level was good, but was still below the defined threshold of 85%. Factors such as age, sex, alcohol consumption, smoking, lack of sputum conversion at two months of treatment and HIV affected the success of TB treatment.
汇总全球结核病（TB）治疗结果，并分析影响成功治疗 TB 的预测因素。
检索 2014 年至 2019 年期间发表的报告肺 TB 治疗结果及影响这些结果的因素的研究。根据 Newcastle-Ottawa 质量评估量表评估研究质量。采用随机效应模型计算合并优势比（OR）和 95%置信区间（CI）。本综述于 2019 年 2 月在国际前瞻性系统评价注册库（PROSPERO）以 CRD42019121512 号注册。
共有 151 项研究符合纳入本综述的标准。成人药物敏感 TB 治疗成功率为 80.1%（95%CI：78.4-81.7）。美洲的治疗成功率最低，为 75.9%（95%CI：73.8-77.9），而大洋洲的治疗成功率最高，为 83.9%（95%CI：75.2-91.0）。儿童的成功率为 84.8%（95%CI：77.7-90.7）；HIV 合并感染患者的成功率为 71.0%（95%CI：63.7-77.8），耐多药结核病患者的成功率为 58.4%（95%CI：51.4-64.6），广泛耐药结核病患者的成功率为 27.1%（12.7-44.5）。治疗后两个月痰涂片阴性的患者成功治疗的可能性几乎高出三倍（OR 2.7；1.5-4.8），而年龄小于 65 岁（OR 2.0；1.7-2.4）、不饮酒（OR 2.0；1.6-2.4）和 HIV 阴性的患者（OR 1.9；1.6-2.5）成功治疗的可能性则高出两倍。
全球 TB 治疗成功率良好，但仍低于 85%的既定阈值。年龄、性别、饮酒、吸烟、治疗两个月时痰培养转阴以及 HIV 等因素均影响 TB 治疗的成功率。
