厄立特里亚北红海地区结核病治疗失败结局的决定因素。
Determinants of unsuccessful tuberculosis treatment outcome in Northern Red Sea region, Eritrea.
机构信息
National TB and Leprosy Control Program, Ministry of Health, Asmara, Eritrea.
Human Resource Development, Planning and Policy, Ministry of Health, Asmara, Eritrea.
出版信息
PLoS One. 2022 Aug 15;17(8):e0273069. doi: 10.1371/journal.pone.0273069. eCollection 2022.
BACKGROUND
Eritrea has achieved the global target (90%) for tuberculosis (TB) treatment success rate. Though, events of unsuccessful TB treatment outcomes (death, treatment failure, lost to follow up and not evaluated) could lead to further TB transmission and the development of resistant strains. Hence, factors related to these events should be explored and addressed. This study aims to fill the gap in evidence by identifying the determinants of unsuccessful TB treatment outcomes in Eritrea's Northern Red Sea region.
METHODS
A retrospective cohort study was conducted in Eritrea's Northern Red Sea region. Data collected using a data extraction tool was analyzed using Stata version 13. Frequencies, proportions, median and standard deviations were used to describe the data. Furthermore, univariable and multivariable logistic regression analysis were performed to determine the risk factors for unsuccessful TB treatment outcomes. Crude odds ratio (COR) and adjusted odds ratio (AOR) with their 95% confidence interval (CI) presented and p-value < 0.05 was considered statistically significant.
RESULTS
Among 1227 TB patients included in this study, 9.6% had unsuccessful TB treatment outcomes. In multivariable logistic regression analysis, TB cases 55-64 years old (AOR: 2.75[CI: 1.21-6.32], p = 0.016) and those ≥ 65 years old (AOR: 4.02[CI: 1.72-9.45], p = 0.001) had 2.7 and 4 times higher likelihood of unsuccessful TB treatment outcome respectively. In addition, HIV positive TB patients (AOR: 5.13[CI: 1.87-14.06], p = 0.002) were 5 times more likely to have unsuccessful TB treatment outcome. TB treatment in Ghindae Regional Referral Hospital (AOR: 5.01[2.61-9.61], p < 0.001), Massawa Hospital (AOR: 4.35[2.28-8.30], p< 0.001) and Nakfa Hospital (AOR: 2.53[1.15-5.53], p = 0.021) was associated with 5, 4 and 2.5 higher odds of unsuccessful TB treatment outcome respectively.
CONCLUSION
In this setting, old age, HIV co-infection and health facility were the independent predictors of unsuccessful TB treatment outcome.
背景
厄立特里亚已实现结核病（TB）治疗成功率全球目标（90%）。然而，TB 治疗结果失败（死亡、治疗失败、失访和未评估）的事件可能导致进一步的 TB 传播和耐药株的产生。因此，应该探讨和解决与这些事件相关的因素。本研究旨在通过确定厄立特里亚北红海地区 TB 治疗结果失败的决定因素来填补这一证据空白。
方法
本研究在厄立特里亚北红海地区开展了一项回顾性队列研究。使用数据提取工具收集的数据使用 Stata 版本 13 进行分析。使用频率、比例、中位数和标准差来描述数据。此外，还进行了单变量和多变量逻辑回归分析，以确定 TB 治疗结果失败的风险因素。呈现了粗比值比（COR）和调整比值比（AOR）及其 95%置信区间（CI），p 值<0.05 被认为具有统计学意义。
结果
在本研究纳入的 1227 例 TB 患者中，有 9.6%的患者 TB 治疗结果失败。在多变量逻辑回归分析中，年龄在 55-64 岁（AOR：2.75[CI：1.21-6.32]，p=0.016）和年龄≥65 岁（AOR：4.02[CI：1.72-9.45]，p=0.001）的 TB 病例发生 TB 治疗结果失败的可能性分别是前者的 2.7 倍和后者的 4 倍。此外，HIV 阳性的 TB 患者（AOR：5.13[CI：1.87-14.06]，p=0.002）发生 TB 治疗结果失败的可能性是前者的 5 倍。在 Ghindae 地区转诊医院（AOR：5.01[2.61-9.61]，p<0.001）、马萨瓦医院（AOR：4.35[2.28-8.30]，p<0.001）和 Nakfa 医院（AOR：2.53[1.15-5.53]，p=0.021）进行 TB 治疗与 TB 治疗结果失败的几率分别增加 5 倍、4 倍和 2.5 倍相关。
结论
在这一背景下，年龄较大、HIV 合并感染和医疗机构是 TB 治疗结果失败的独立预测因素。
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