Department of Paediatrics, Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria.
Bowen University College of Medicine Iwo, Iwo, Osun State, Nigeria.
PLoS One. 2020 Oct 29;15(10):e0239225. doi: 10.1371/journal.pone.0239225. eCollection 2020.
Tuberculosis (TB) remains a global health challenge and leading infectious killer worldwide. The need for continuous evaluation of TB treatment outcomes becomes more imperative in the midst of a global economic meltdown substantially impacting resource-limited-settings.
This study retrospectively reviewed 25-years of treatment outcomes in 3,384 patients who were managed for TB at a tertiary hospital in Nigeria. Confirmed TB cases were given directly observed therapy of a short-course treatment regimen and monitored for clinical response.
Out of 1,146,560 patients screened, there were 24,330 (2.1%) presumptive and 3,384 (13.9%) confirmed TB cases. The patients' mean age was 35.8 years (0.33-101 years). There were 1,902 (56.2%) male, 332(9.8%) pediatric, and 2,878 (85%) pulmonary TB cases. The annual mean measured treatment outcomes were as follows: adherence, 91.4(±5.8) %; successful outcome, 75.3(±8.8) % potentially unsatisfactory outcome, 14.8(±7.2) %; and mortality 10.0(±3.6) %. Female, extra-pulmonary TB (EPTB), newly diagnosed, and relapsed patients compliant with treatment had successful outcomes. Adulthood and HIV infection were mortality risk factors.
The mean annual successful treatment outcome is 75.3(±8.8) %. Female, pediatric, EPTB, new, and relapsed patients were predisposed to successful treatment outcomes. Lessons learned will guide future program modifications.
结核病(TB)仍然是一个全球性的健康挑战,也是全球主要的传染性杀手。在全球经济崩溃严重影响资源有限的环境的情况下,需要不断评估结核病治疗结果,这一点变得更加迫切。
本研究回顾性分析了尼日利亚一家三级医院 25 年来治疗的 3384 例结核病患者的治疗结果。确诊的结核病患者接受了短程治疗方案的直接观察治疗,并监测临床反应。
在筛查的 1146560 名患者中,有 24330 名(2.1%)疑似和 3384 名(13.9%)确诊结核病患者。患者的平均年龄为 35.8 岁(0.33-101 岁)。有 1902 名(56.2%)男性、332 名(9.8%)儿科和 2878 名(85%)肺结核患者。每年平均治疗结果如下:依从性为 91.4(±5.8)%;治疗成功的比例为 75.3(±8.8)%;可能不满意的结果为 14.8(±7.2)%;死亡率为 10.0(±3.6)%。女性、肺外结核病(EPTB)、新诊断和复发患者对治疗的依从性好,治疗结果成功。成年和 HIV 感染是死亡的危险因素。
每年平均治疗成功率为 75.3(±8.8)%。女性、儿科、EPTB、新诊断和复发患者更倾向于成功治疗。从中吸取的经验教训将指导未来的项目修改。