Chilembo M, Oguri S, Matsuoka Y, Ota M, Musiankuni P, Kabungo J
Japan Anti-Tuberculosis Association, Lusaka, Zambia.
Research Institute of Tuberculosis, Tokyo, Japan.
Public Health Action. 2020 Mar 21;10(1):21-26. doi: 10.5588/pha.19.0059.
Four tuberculosis (TB) diagnostic health facilities of the Chongwe District, Zambia.
To determine the frequency of bacteriologically confirmed TB patients lost to follow-up (LTFU) before treatment from January to December 2017.
This is a retrospective cohort study involving the review of TB registers. Information on presumptive TB patients who tested positive either by smear microscopy or Xpert MTB/RIF assay was extracted from the laboratory TB registers of the TB diagnostic facilities and cross-matched with the TB treatment registers of TB treatment facilities.
Two hundred and seventeen bacteriologically confirmed TB patients were found in the laboratory TB registers. Of these, 145 (67%) were males and seven (3%) were children; 177 (81%) patients were diagnosed using Xpert, while the remaining 40 (19%) were diagnosed using sputum smear microscopy. A total of 71 (33%) were not linked to treatment. Those diagnosed using smear microscopy were 2.5 times (95% CI 1.1-5.3) more likely to be LTFU before treatment than those diagnosed using Xpert.
About one third of TB patients who were not linked to treatment could potentially extend the duration of bacilli transmission in their communities. National TB control programmes should consider including LTFU patients before treatment in routine monitoring and evaluation.
赞比亚宗韦区的四家结核病诊断医疗机构。
确定2017年1月至12月治疗前细菌学确诊的结核病患者失访（LTFU）的频率。
这是一项回顾性队列研究，涉及审查结核病登记册。从结核病诊断机构的实验室结核病登记册中提取通过涂片显微镜检查或Xpert MTB/RIF检测呈阳性的疑似结核病患者的信息，并与结核病治疗机构的结核病治疗登记册进行交叉核对。
在实验室结核病登记册中发现了217例细菌学确诊的结核病患者。其中，145例（67%）为男性，7例（3%）为儿童；177例（81%）患者通过Xpert诊断，其余40例（19%）通过痰涂片显微镜检查诊断。共有71例（33%）未与治疗建立联系。与通过Xpert诊断的患者相比，通过涂片显微镜检查诊断的患者在治疗前失访的可能性高出2.5倍（95%置信区间1.1 - 5.3）。
约三分之一未与治疗建立联系的结核病患者可能会延长其社区内杆菌传播的持续时间。国家结核病控制规划应考虑将治疗前失访患者纳入常规监测和评估。
