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在埃塞俄比亚,耐多药结核病患者的治疗结果不佳及其预测因素:系统评价和荟萃分析。

Poor treatment outcome and its predictors among drug-resistant tuberculosis patients in Ethiopia: A systematic review and meta-analysis.

机构信息

Ethiopian Public Health Institute, Addis Ababa, Ethiopia.

St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

出版信息

Int J Infect Dis. 2020 Sep;98:420-439. doi: 10.1016/j.ijid.2020.05.087. Epub 2020 Jul 6.

Abstract

OBJECTIVE

To assess poor treatment outcomes and their predictors among drug-resistant tuberculosis patients treated in Ethiopia.

METHODS

Data were searched from both electronic databases and other sources. From the whole search, 404 articles were reviewed and 17 articles that fulfilled the inclusion criteria were included in the analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed and Joanna Briggs Institute Critical Appraisal checklist was used for assessing the quality. Risk of bias was assessed using forest plot and Egger's regression test. Data were analyzed using STATA version 15 and Review Manager Software version 5.3.

RESULTS

The overall pooled proportion of poor treatment outcome and mortality was 17.86% and 15.13% respectively. The incidence density rate of poor treatment outcome and mortality was 10.41/1000 person-months and 9.28/1000 person-months respectively. Survival status and successful treatment outcomes were 76.97% and 63.82% respectively. HIV positivity, non-HIV comorbidities, clinical complications, extrapulmonary involvement, undernutrition, anemia, treatment delay, lower body weight, and older age were the predictors of poor treatment outcome.

CONCLUSION

Better survival and treatment success rates were noted in Ethiopia as compared to the global average. The majority of the poor treatment outcomes occurred within the intensive phase. Early initiation of anti-tuberculosis treatment would be important for successful treatment outcomes.

摘要

目的

评估在埃塞俄比亚接受治疗的耐多药结核病患者的不良治疗结局及其预测因素。

方法

从电子数据库和其他来源搜索数据。从整个搜索中,审查了 404 篇文章,并纳入了 17 篇符合纳入标准的文章进行分析。遵循系统评价和荟萃分析报告的首选项目清单,并使用 Joanna Briggs 研究所批判性评估清单评估质量。使用森林图和 Egger 回归检验评估偏倚风险。使用 STATA 版本 15 和 Review Manager 软件版本 5.3 进行数据分析。

结果

总体不良治疗结局和死亡率的合并比例分别为 17.86%和 15.13%。不良治疗结局和死亡率的发生率密度分别为 10.41/1000人月和 9.28/1000人月。生存状态和治疗成功的比例分别为 76.97%和 63.82%。HIV 阳性、非 HIV 合并症、临床并发症、肺外受累、营养不良、贫血、治疗延迟、较低的体重和年龄较大是不良治疗结局的预测因素。

结论

与全球平均水平相比,埃塞俄比亚的生存率和治疗成功率更高。大多数不良治疗结局发生在强化期内。尽早开始抗结核治疗对于获得成功的治疗结果非常重要。

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