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喀麦隆巴门达地区医院对接受治疗的艾滋病毒感染者结核病预测因素的一项为期四年的基于医院的回顾性研究。

A Four-Year Hospital-Based Retrospective Study of the Predictors of Tuberculosis in People Living with HIV and Receiving Care at Bamenda Regional Hospital, Cameroon.

作者信息

Anye Cho Sabastine, Nkfusai Claude Ngwayu, Yankam Brenda Mbouamba, Wirsiy Frankline Sevidzem, Tsoka-Gwegweni Joyce Mahlako, Cumber Samuel Nambile

机构信息

Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon.

Cameroon Baptist Convention Health Services, Yaounde, Cameroon.

出版信息

Int J MCH AIDS. 2020;9(2):167-172. doi: 10.21106/ijma.299. Epub 2020 Feb 18.

Abstract

BACKGROUND

Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) co-infections place immense burdens on healthcare systems with particularly diagnostic and therapeutic challenges. TB is high among opportunistic diseases and the most leading cause of death among patients with HIV/AIDS. HIV infection is the most-known risk factor for Mycobacterium tuberculosis infection and progression to active disease, which increases the risk of latent TB reactivation by 20-fold. We present a four-year descriptive analysis of TB in people living with HIV in the Bamenda Regional Hospital (BRH) from 2012-2016.

METHODS

This was a hospital-based descriptive chart review. We conducted manual reviews of medical records of HIV/TB co-infected patients from June 2017-July 2017 at BRH's AIDS Treatment Centre, North West region of Cameroon. Socio-demographic and clinical characteristics of cases were captured using a pre-tested data collection sheet and analyzed with Statistical Package for Social Sciences (SPSS) software, version 25.

RESULTS

Out of the 1078 HIV patients, 36.5% (393) of them were diagnosed with TB; 75% (808) of the People living with HIV (PLWHIV) were active; among the remaining 25%, 10.2% were bedridden, 13.0% were jobless, and 1.8% were retired. The greater proportion of the participants were females 65.5% (705).

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

The baseline anemia, smoking tobacco, drinking alcohol, detectable (≥50copies/mL), CD4 count ≤ 200cells/µl and gender of the PLWHIV were associated with the incidence of TB. We recommend early diagnosis and treatment of anemia, modification of patient's lifestyle, and strengthening of immunization programs to reduce the risk of TB occurrence among HIV-infected people.

摘要

背景

结核病(TB)与人类免疫缺陷病毒(HIV)合并感染给医疗系统带来了巨大负担,尤其是在诊断和治疗方面面临挑战。在机会性疾病中,结核病发病率很高,是HIV/AIDS患者死亡的主要原因。HIV感染是已知的结核分枝杆菌感染和发展为活动性疾病的最重要危险因素,会使潜伏性结核病再激活的风险增加20倍。我们对2012年至2016年期间巴门达地区医院(BRH)感染HIV的患者中的结核病进行了为期四年的描述性分析。

方法

这是一项基于医院的描述性图表回顾研究。我们于2017年6月至7月在喀麦隆西北地区BRH的艾滋病治疗中心对HIV/TB合并感染患者的病历进行了人工查阅。使用预先测试的数据收集表记录病例的社会人口统计学和临床特征,并使用社会科学统计软件包(SPSS)25版进行分析。

结果

在1078名HIV患者中,36.5%(393例)被诊断患有结核病;75%(808例)的HIV感染者(PLWHIV)处于活动期;在其余25%中,10.2%卧床不起,13.0%失业,1.8%退休。参与者中女性占比更大,为65.5%(705例)。

结论及对全球健康的影响

HIV感染者的基线贫血、吸烟、饮酒、可检测到(≥50拷贝/毫升)、CD4计数≤200细胞/微升以及性别与结核病发病率相关。我们建议对贫血进行早期诊断和治疗,改变患者生活方式,并加强免疫规划,以降低HIV感染者中结核病发生的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a39f/7083178/38e26247cc89/IJMA-9-167-g001.jpg

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