博茨瓦纳奎嫩西区结核病死亡率的结果和预测因素：一项回顾性队列研究。

Outcomes and predictors of tuberculosis mortality in Kweneng West District, Botswana: a retrospective cohort study.

机构信息

Department of Family Medicine and Public Health, University of Botswana, Gaborone, Botswana.

Department of Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana.

出版信息

Pan Afr Med J. 2022 May 2;42:1. doi: 10.11604/pamj.2022.42.1.32381. eCollection 2022.

DOI:10.11604/pamj.2022.42.1.32381

PMID:35685381

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9142783/

Abstract

INTRODUCTION

Botswana is among the countries with the highest tuberculosis (TB) notification rates in the world. However, there is paucity of data on the outcomes and predictors of TB mortality at district level in Botswana. This study was aimed at describing the TB outcomes and identifying the predictors of mortality in Kweneng West district, Botswana.

METHODS

this was a retrospective cohort study of TB outcomes in Kweneng West, from January 2008 to December 2016. All documented drug-sensitive TB (DS-TB) patients aged 16 years and above were included. The World Health Organization (WHO) definitions of treatment outcomes for DS-TB were used. Binary logistic regression was used to identify predictors of mortality.

RESULTS

there were 1475 TB notifications in the study period. The median age was 36 years and 41.5% were female. A total of 728 (49.4%) were HIV positive. Pulmonary TB (PTB) accounted for 87.3% of all cases. The overall treatment success rate (TSR) was 81.9% and the mortality rate was 9.4%. Compared to the 16-25 years age group, patients aged more than 65 years had the highest risk of mortality (AOR=9.63). Other significant predictors of mortality were male sex (AOR=1.63), no sputum microscopy (AOR=1.77), positive HIV (AOR=2.13) and unknown HIV status (AOR=4.47). Positive sputum microscopy (AOR=0.50) and extra-pulmonary TB (EPTB) (AOR=0.56) were associated with less mortality.

CONCLUSION

while Botswana has relatively good TB treatment success rates, the mortality rates are high. Public health interventions should target the identified risk factors of mortality.

摘要

简介

博茨瓦纳是世界上结核病（TB）报告发病率最高的国家之一。然而，博茨瓦纳区县级结核病死亡率的结果和预测因素的数据很少。本研究旨在描述科翁尼西部区结核病的结果，并确定博茨瓦纳科翁尼西部区结核病死亡率的预测因素。

方法

这是一项回顾性队列研究，研究对象为 2008 年 1 月至 2016 年 12 月期间博茨瓦纳科翁尼西部区的结核病结果。所有记录的药物敏感型肺结核（DS-TB）患者年龄均在 16 岁及以上。采用世界卫生组织（WHO）对 DS-TB 治疗结果的定义。采用二项逻辑回归分析确定死亡率的预测因素。

结果

研究期间共报告了 1475 例结核病。中位年龄为 36 岁，41.5%为女性。共有 728 例（49.4%）HIV 阳性。所有病例中，肺结核（PTB）占 87.3%。总的治疗成功率（TSR）为 81.9%，死亡率为 9.4%。与 16-25 岁年龄组相比，65 岁以上的患者死亡风险最高（AOR=9.63）。其他显著的死亡预测因素包括男性（AOR=1.63）、无痰镜检（AOR=1.77）、HIV 阳性（AOR=2.13）和未知的 HIV 状态（AOR=4.47）。痰镜检阳性（AOR=0.50）和肺外结核（EPTB）（AOR=0.56）与较低的死亡率相关。