Dorji Thinley, Wangdi Kinley
Kanglung Hospital, Trashigang, Bhutan.
Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia.
Nepal J Epidemiol. 2020 Sep 30;10(3):888-896. doi: 10.3126/nje.v10i3.28397. eCollection 2020 Sep.
Tuberculosis (TB) is one of the major public health problems in Bhutan. Evaluation of treatment outcomes of TB and identification of the risk factors are important components for the success of National TB control program. Therefore, this study was undertaken to assess the TB treatment outcome and factors associated with it in Samtse General Hospital.
This was a retrospective, cross sectional study using the TB data from Samtse General Hospital from 2008-2019. A univariate and multiple logistic regression was used to check for associations between the outcome and other independent variables.
The study included a total of 634 TB patients. Of this, 44.0% (279) were smear positive TB (PTB+), 36.1% (229) were extra pulmonary TB (EPTB) and 19.9% (126) were smear negative TB (PTB-). During the study period, 56.2% (356) of them completed treatment, 33.3% (211) were declared cured, 0.2% (1) had defaulted, 5.1% (32) died and 5.4% (34) had treatment failure. The mean treatment success rate (TSR) was 89.4% (567). The TSR was highest for EPTB with 96.9% (222/229), followed by PTB- at 88.1% (111/126) and lowest for PTB+ with 83.9% (234/279). Successful treatment outcome was observed in EPTB patients (AOR: 7.3; 95% CI: 2.46-21.36), patients in age 15-28 years (AOR: 3.4; 95% CI: 1.59-7.46) and 29-42 years (AOR: 9.1; 95% CI: 2.44-33.61).
The treatment outcome of TB in Samtse General Hospital is satisfactory and at par with the national level. Since, smear positive TB and elderly patients are prone to develop poor treatment outcome, they need to be monitored and followed up adequately.
结核病是不丹主要的公共卫生问题之一。评估结核病的治疗效果并确定风险因素是国家结核病控制项目成功的重要组成部分。因此,本研究旨在评估萨姆策综合医院的结核病治疗效果及其相关因素。
这是一项回顾性横断面研究,使用了萨姆策综合医院2008 - 2019年的结核病数据。采用单因素和多因素逻辑回归分析来检验治疗效果与其他独立变量之间的关联。
该研究共纳入634例结核病患者。其中,44.0%(279例)为涂片阳性结核病(PTB+),36.1%(229例)为肺外结核病(EPTB),19.9%(126例)为涂片阴性结核病(PTB-)。在研究期间,56.2%(356例)患者完成治疗,33.3%(211例)被宣布治愈,0.2%(1例)失访,5.1%(32例)死亡,5.4%(34例)治疗失败。平均治疗成功率(TSR)为89.4%(567例)。EPTB的TSR最高,为96.9%(222/229),其次是PTB-,为88.1%(111/126),PTB+最低,为83.9%(234/279)。EPTB患者(调整后比值比:7.3;95%置信区间:2.46 - 21.36)、15 - 28岁患者(调整后比值比:3.4;95%置信区间:1.59 - 7.46)和29 - 42岁患者(调整后比值比:9.1;95%置信区间:2.44 - 33.61)观察到成功的治疗效果。
萨姆策综合医院的结核病治疗效果令人满意,与国家水平相当。由于涂片阳性结核病患者和老年患者容易出现较差的治疗效果,需要对他们进行充分的监测和随访。