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HIV状态对肺结核患者治疗成功结局的影响及预测因素:一项为期六年的回顾性队列研究。

Impact of HIV status and predictors of successful treatment outcomes among tuberculosis patients: A six-year retrospective cohort study.

作者信息

Fekadu Ginenus, Turi Ebisa, Kasu Tinsae, Bekele Firomsa, Chelkeba Legese, Tolossa Tadesse, Labata Busha Gamachu, Dugassa Dinka, Fetensa Getahun, Diriba Dereje Chala

机构信息

School of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

出版信息

Ann Med Surg (Lond). 2020 Nov 15;60:531-541. doi: 10.1016/j.amsu.2020.11.032. eCollection 2020 Dec.

Abstract

Tuberculosis (TB) remains a major global public health problem. Hence, the study aimed to assess the impact of human immune virus (HIV) status and predictors of successful treatment outcomes of TB patients enrolled at Nekemte specialized hospital. An institution-based retrospective cohort study was conducted and the data analyzed using SPSS version 24.0. A multivariable logistic regression model was fitted to identify the association between treatment outcome and potential predictor variables. The association was calculated using the Adjusted Odds ratio (AOR) and the statistical significance was considered at p < 0.05. Out of the total 506 study participants, 50.2% of them were males. The overall treatment success rate was 81.4% and 58.06% among HIV co-infected TB patients. Female sex (AOR = 2.01, 95%CI: 1.04-16.11), age 25-34 years (AOR = 3.982, 95%CI: 1.445-10.971), age 35-49 years (AOR = 5.392, 95%CI: 1.674-17.368), high school educational level (AOR = 5.330, 95% CI: 1.753-16.209), urban residence (AOR = 3.093, 95%CI: 1.003-9.541) and HIV negative (AOR = 10.3, 95%CI, 3.216-32.968) were positively associated with favorable TB treatment outcome. Whereas, being single (AOR = 0.293, 95%CI: 0.1-0.854), smear-negative pulmonary TB (AOR = 0.360, 95%CI: 0.156-0.834), extra-pulmonary TB (AOR = 0.839, 95%CI: 0.560-0.955) and retreatment case (AOR: 0.54, 95%CI: 0.004-0.098) were negatively associated with successful treatment outcome. The treatment success rate of TB patients was lower than World Health Organization target set of 85%. The increased unsuccessful outcome among TB/HIV patients requires urgent public health interventions to improve the evaluation policy and control framework.

摘要

结核病(TB)仍然是一个重大的全球公共卫生问题。因此,本研究旨在评估人类免疫病毒(HIV)状态对在Nekemte专科医院登记的结核病患者成功治疗结果的影响以及预测因素。开展了一项基于机构的回顾性队列研究,并使用SPSS 24.0版对数据进行分析。拟合多变量逻辑回归模型以确定治疗结果与潜在预测变量之间的关联。使用调整后的优势比(AOR)计算关联,并将p < 0.05视为具有统计学意义。在总共506名研究参与者中,50.2%为男性。HIV合并感染的结核病患者的总体治疗成功率分别为81.4%和58.06%。女性(AOR = 2.01,95%CI:l.04 - 16.11)、25 - 34岁(AOR = 3.982,95%CI:1.445 - 10.971)、35 - 49岁(AOR = 5.392,95%CI:1.674 - 17.368)、高中教育水平(AOR = 5.330,95%CI:1.753 - 16.209))、城市居住(AOR = 3.093,95%CI:1.003 - 9.541)和HIV阴性(AOR = 10.3, 95%CI, 3.216 - 32.968)与结核病治疗结果良好呈正相关。而单身(AOR = 0.293,95%CI:0.1 - 0.854)、涂片阴性肺结核(AOR = 0.360,95%CI:0.156 - 0.834)、肺外结核(AOR = 0.839,95%CI:0.560 - 0.955)和复治病例(AOR:0.54,95%CI:0.004 - 0.098)与成功治疗结果呈负相关。结核病患者的治疗成功率低于世界卫生组织设定的85%的目标。结核病/HIV患者中治疗失败率的增加需要紧急的公共卫生干预措施,以改善评估政策和控制框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1298/7704363/405a28db4711/gr1.jpg

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