Medina Angélica, López Lucelly, Martínez Celia, Aguirre Sarita, Alarcón Edith
Programa Nacional de Control de la Tuberculosis Ministerio de Salud Pública y Bienestar Social Asunción Paraguay Programa Nacional de Control de la Tuberculosis, Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay.
Universidad Pontificia Bolivariana Universidad Pontificia Bolivariana Medellín Colombia Universidad Pontificia Bolivariana, Medellín, Colombia.
Rev Panam Salud Publica. 2019 Dec 20;43:e102. doi: 10.26633/RPSP.2019.102. eCollection 2019.
To describe the socio-demographic and clinical-epidemiological characteristics and to determine the factors associated with the mortality of people diagnosed with tuberculosis (TB) in Paraguay.
Operational research with a retrospective cohort design of cases diagnosed with TB in Paraguay between 2015-2016. The database of the National Tuberculosis Control Program was used. Chi-square and relative risk (RR) tests with a 95% confidence interval (95% CI) were used to determine the factors associated with mortality; in addition, a robust Poisson multiple regression model was adjusted. A significance level of 5% was used.
Five hundred and forty-one cases of TB were studied, of which 11.5% died. The factors increasing the risk of death were male sex (RR 1.26; 95% CI 1.1-1.50), infection with human immunodeficiency virus (RR 4.78; 95% CI 4.04-5.65) and chronic obstructive pulmonary disease (RR 1.70; 95% CI 1.19-2.42). Being deprived of one's liberty was a protective factor (RR 0.37; 95% CI 0.24-0.61).
The highest risk of death is presented by men and people with TB/HIV coinfection and the lowest risk is presented by people deprived of liberty. There is a need to improve diagnosis and follow-up of TB cases, with effective implementation of directly observed treatment (DOTS) and timely management of associated diseases such as HIV and chronic obstructive pulmonary disease.
描述巴拉圭结核病患者的社会人口学和临床流行病学特征,并确定与结核病患者死亡相关的因素。
采用回顾性队列研究方法,对2015年至2016年期间在巴拉圭诊断为结核病的病例进行研究。使用国家结核病控制项目的数据库。采用卡方检验和相对风险(RR)检验以及95%置信区间(95%CI)来确定与死亡率相关的因素;此外,还调整了稳健的泊松多元回归模型。使用5%的显著性水平。
共研究了541例结核病病例,其中11.5%死亡。增加死亡风险的因素包括男性(RR 1.26;95%CI 1.1 - 1.50)、感染人类免疫缺陷病毒(RR 4.78;95%CI 4.04 - 5.65)和慢性阻塞性肺疾病(RR 1.70;95%CI 1.19 - 2.42)。被剥夺自由是一个保护因素(RR 0.37;95%CI 0.24 - 0.61)。
男性和合并感染结核病/艾滋病病毒的患者死亡风险最高,被剥夺自由的患者死亡风险最低。有必要改善结核病病例的诊断和随访,有效实施直接观察治疗(DOTS),并及时管理如艾滋病病毒和慢性阻塞性肺疾病等相关疾病。