Johnson July Mary, Mohapatra Aswini Kumar, Velladath Saleena Ummer, Shettigar Kavitha S
Department of Medical Laboratory Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Pulmonary Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Int J Mycobacteriol. 2022 Jan-Mar;11(1):38-46. doi: 10.4103/ijmy.ijmy_244_21.
In this study, we evaluate the predictors of treatment outcomes in drug resistant tuberculosis.
An observational retrospective study was conducted by using the medical records of patients confirmed for TB at Kasturba Medical College from January 2015 to December 2018.
Four hundred and sixty-two TB patients were included in this study. Of the total TB-confirmed patients, about 85.1% are diagnosed with pulmonary TB (PTB) (n = 393), 11.7% were extrapulmonary tuberculosis (EPTB) (n = 54), and 3.2% (n = 15) cases had both PTB and EPTB. Among the 462 cases, the frequency of multidrug-resistant TB (MDR-TB) was 25% (n = 117), extensively drug-resistant TB was 1% (n = 3), and non-MDR cases were 74% (n = 342). The frequency of unsuccessful treatment outcome was 92.9% (n = 429) and successful outcome was 7.1% (n = 33). There were 68.2% of new and 31.8% retreatment cases of TB. HIV co-infection was found in 2.3% (n = 14) of TB cases, and among them, 64.3% (n = 9) were found in PTB cases. The major comorbidities found were diabetes (21.2%), weight loss (12.6%), and anemia (12.6%). There was a difference in rate of PTB cases across years decreasing in the year 2017, whereas ETB cases were increasing in the year 2017. The TB treatment success rate was increased from 2015 (4.8%) to 2018 (8.3%).
The higher rate of poor treatment outcome emphasizes the need of improvement in TB surveillance, treatment, more stringent follow-up, monitoring, and patient education to ensure complete and successful treatment.
在本研究中，我们评估了耐多药结核病治疗结果的预测因素。
通过使用卡斯图尔巴医学院2015年1月至2018年12月确诊为结核病患者的病历进行了一项观察性回顾性研究。
本研究纳入了462例结核病患者。在所有确诊为结核病的患者中，约85.1%被诊断为肺结核（PTB）（n = 393），11.7%为肺外结核（EPTB）（n = 54），3.2%（n = 15）的病例同时患有PTB和EPTB。在这462例病例中，耐多药结核病（MDR-TB）的发生率为25%（n = 117），广泛耐药结核病为1%（n = 3），非MDR病例为74%（n = 342）。治疗结果未成功的发生率为92.9%（n = 429），成功的发生率为7.1%（n = 33）。结核病新发病例占68.2%，复发病例占31.8%。2.3%（n = 14）的结核病病例合并感染HIV，其中64.3%（n = 9）见于PTB病例。发现的主要合并症有糖尿病（21.2%）、体重减轻（12.6%）和贫血（12.6%）。PTB病例数在2017年呈下降趋势，而EPTB病例数在2017年呈上升趋势，各年份之间存在差异。结核病治疗成功率从2015年（4.8%）提高到了2018年（8.3%）。
较高的治疗失败率强调需要改进结核病监测、治疗、更严格的随访、监测以及患者教育，以确保治疗的完整和成功。
