Requena-Herrera María P, Bedoya-Ismodes Enrique O, Vitorino José Aymar, Soto Alonso
Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú.
Rev Chilena Infectol. 2019 Dec;36(6):723-731. doi: 10.4067/S0716-10182019000600723.
Mental health problems in people with tuberculosis (TB) have been associated with negative outcomes. Some health care centers in Peru use an evaluation of mental health status proposed by the Dirección de Prevención y Control de Tuberculosis (DPCTB).
To evaluate the association between the mental health evaluation indicators at the beginning of treatment and the outcome of people treated with TB.
A retrospective cohort study in three health care centers from the district San Juan de Miraflores. The outcome was considered positive (cured) and negative (failure, dropout, death or change of treatment scheme).
A significant association was found between the negative outcome and depressive symptoms (RR: 2.39, 95%CI: 1.19-4.78), substance abuse (RR: 2.58; 95%CI: 1.31-5.09) and unprotected sexual intercourse (p = 0.04). The multivariate analysis found association with depressive symptoms (RR: 2.19, 95%CI: 1.10-4.35) and substance abuse (RR: 2.19, 95%CI: 1.14-4.20).
Depressive symptoms and drug consumption were associated with negative outcomes. Intervention studies focusing on these factors should be evaluated to improve treatment success.
结核病患者的心理健康问题与不良后果相关。秘鲁的一些医疗保健中心采用了结核病预防与控制司（DPCTB）提出的心理健康状况评估方法。
评估治疗开始时的心理健康评估指标与结核病治疗患者结局之间的关联。
在圣胡安·德米拉弗洛雷斯区的三个医疗保健中心进行一项回顾性队列研究。结局被视为阳性（治愈）和阴性（治疗失败、退出、死亡或治疗方案改变）。
发现不良结局与抑郁症状（相对危险度：2.39，95%可信区间：1.19 - 4.78）、药物滥用（相对危险度：2.58；95%可信区间：1.31 - 5.09）和无保护性行为（p = 0.04）之间存在显著关联。多变量分析发现与抑郁症状（相对危险度：2.19，95%可信区间：1.10 - 4.35）和药物滥用（相对危险度：2.19，95%可信区间：1.14 - 4.20）有关联。
抑郁症状和药物消费与不良结局相关。应评估针对这些因素的干预研究，以提高治疗成功率。
