Dash Manoranjan, Behera Bibhu Prasad
Department of TB & Chest, SCB Medical College and Hospital, Cuttack, Odisha, India.
Department of Internal Medicine, SLN Medical College and Hospital, Koraput, Odisha, India.
J Family Med Prim Care. 2022 Apr;11(4):1275-1281. doi: 10.4103/jfmpc.jfmpc_1015_21. Epub 2022 Mar 18.
India accounts for one-fourth of the global TB burden. The load of drug-resistant TB is of foremost attention and concern at international, regional, and national levels. As per estimates of TB burden in India in 2018, the MDR/RR-TB incidence was 1.30 lakhs.
Socioepidemiological status and clinical outcome of MDR TB patients in a teaching hospital in tribal area of southern Odisha from 2012-2020.
This is a retrospective observational study accepted by the Institutional Ethics Committee of this tertiary medical college & hospital to which the DRTB centre is attached with the agreement of the program administrators.
Patients with >15 years of age, those patients with pulmonary and extrapulmonary tuberculosis with normal liver enzymes.
Patients having abnormal liver enzymes before treatment, pregnant ladies and children <15 years of age.
A total of 40 MDR TB patients were included. The patients' mean age was 36.65 ± 11.75 years. 65% of the patients had BMI below 18.5 kg/m. 17.5% of patients had comorbidities. Approximately 45% had successful treatment outcomes. Poor treatment outcome includes loss to follow-up in 22.5% and mortality in 12.5%. We did not find any treatment failure.
Treatment success outcomes occurred in less than half of the cases. The main predictors of mortality among MDR-TB patients were the presence of comorbidities like anaemia, baseline leucocytosis or lymphopenia, hypoproteinaemia, HIV sero-positivity and smaller baseline BMI.
印度的结核病负担占全球的四分之一。耐多药结核病的负担在国际、区域和国家层面都备受关注。根据2018年印度结核病负担估计，耐多药/利福平耐药结核病发病率为13万。
2012年至2020年期间，奥里萨邦南部部落地区一家教学医院耐多药结核病患者的社会流行病学状况及临床结局。
这是一项回顾性观察性研究，经该三级医学院及附属医院的机构伦理委员会批准，在项目管理人员同意下，耐多药结核病中心参与其中。
年龄大于15岁、患有肺结核和肺外结核且肝酶正常的患者。
治疗前肝酶异常的患者、孕妇及15岁以下儿童。
共纳入40例耐多药结核病患者。患者平均年龄为36.65±11.75岁。65%的患者体重指数低于18.5kg/m。17.5%的患者有合并症。约45%的患者治疗成功。治疗效果不佳包括22.5%的患者失访和12.5%的患者死亡。未发现治疗失败病例。
不到一半的病例治疗成功。耐多药结核病患者死亡的主要预测因素包括合并症，如贫血、基线白细胞增多或淋巴细胞减少、低蛋白血症、HIV血清阳性以及较小的基线体重指数。
