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中国常规规划环境中成功治疗的患者在 7 年随访期内的结核病复发情况:一项前瞻性纵向研究。

Tuberculosis recurrence over a 7-year follow-up period in successfully treated patients in a routine program setting in China: a prospective longitudinal study.

机构信息

International Union Against Tuberculosis and Lung Disease, Paris, France.

Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China.

出版信息

Int J Infect Dis. 2021 Sep;110:403-409. doi: 10.1016/j.ijid.2021.07.057. Epub 2021 Jul 29.

Abstract

OBJECTIVES

To determine tuberculosis (TB) recurrence in previously successfully treated patients in a routine program setting and baseline characteristics associated with TB recurrence.

METHODS

A prospective longitudinal study in Jiangxi Province, China. Patients, ≥14 years old, were consecutively registered and were followed up for seven years to assess TB recurrence against a patients' individual baseline data that had been entered into a database at TB registration.

RESULTS

There were 800 TB patients registered at baseline, and 634 (79.2%) of them completed anti-TB treatments. Fifty-nine (9.3%) died, and 21 (3.3%) were lost to follow-up over the follow-up period. There were 96 patients with recurrent episodes (total incidence 15.2% or annual incidence 2,200/100,000). Of the recurrent cases, 53 (55.2%) happened within 2-year after completion of anti-TB treatments. After controlling confounding factors, the risk of TB recurrence was significantly higher in the age range 34-73 years (P<0.01) and current smokers (P<0.01).

CONCLUSIONS

Overall recurrence rate among previously treated TB patients was much higher than the initial incidence in the same population (61-98/100,000) and settings with similar TB incidence. TB programs should consider closer monitoring of these patients for early detection of recurrence. Particular attention should be given to those between 34-73 years and those who use tobacco products.

摘要

目的

在常规规划环境中确定先前成功治疗的患者中的结核病(TB)复发情况,以及与 TB 复发相关的基线特征。

方法

在中国江西省进行的一项前瞻性纵向研究。连续登记患者,随访 7 年,以评估 TB 复发情况,将患者个体的基线数据与在 TB 登记时输入数据库的数据进行对照。

结果

在基线时有 800 名 TB 患者登记,其中 634 名(79.2%)完成了抗 TB 治疗。59 名(9.3%)死亡,21 名(3.3%)在随访期间失访。有 96 名患者出现复发(总发生率为 15.2%或年发生率为 2200/100,000)。在复发病例中,53 例(55.2%)发生在完成抗 TB 治疗后 2 年内。在控制混杂因素后,34-73 岁年龄组(P<0.01)和当前吸烟者(P<0.01)TB 复发的风险显著更高。

结论

与同一人群(61-98/100,000)和具有相似 TB 发病率的环境中的初始发病率相比,先前治疗的 TB 患者的总体复发率要高得多。TB 规划应考虑对这些患者进行更密切的监测,以早期发现复发。特别应关注 34-73 岁之间和使用烟草制品的患者。

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