Omer Abdurahman Abibeker, Meshesha Meiraf Daniel, Ajema Abraham Teka, Yoo Samuel D
Department of Internal Medicine, Dilchora Hospital, Dire Dawa, Ethiopia.
Department of Internal Medicine, Dilla University, Dilla, Ethiopia.
Infect Drug Resist. 2022 Aug 22;15:4707-4719. doi: 10.2147/IDR.S377238. eCollection 2022.
The emergence of drug resistance in TB treatment is a major public health threat. However, there are limited studies which are directed towards identifying factors that explain the gap in achieving treatment targets.
: This study aimed to assess the treatment outcome and its associated factors among patients with MDR/RR-TB in Dilchora Hospital Treatment Initiation Center from January 2014 to December 2018.
: A retrospective cross-sectional study was conducted on patients with MDR/RR TB who initiated treatment between January 2014 and December 2018. Data were extracted from patient medical charts using a structured questionnaire. SPSS version 26 was used for analysis. Reports are presented using percentages and frequency. Independently associated factors for unfavorable outcome were identified using binary logistic regression model. Adjusted and crude odds ratio with 95% CI was used. P-value less than 0.05 was used to declare statistical significance.
: A total of 146 patients were included in this study. The overall prevalence of unfavorable outcomes in this study for those with known outcomes was 8.6%. People living with HIV had a 6.47 times (95% CI: 1.14-36.68) increased odds of death as compared to those who are HIV negative. For every 1kg/m increment in BMI, there was a 35.3% (AOR = 0.647; CI: 0.44-0.95) reduction in the odds of death as compared to those who had a 1kg/m2 lower BMI. Each additional month without culture conversion also increased the odds of death 2.24 times (95%CI: 1.08-4.66).
CONCLUSION & RECOMMENDATION: : The findings of our study showed an appreciably low poor treatment outcome for this outpatient program. HIV screening and early initiation of HAART, early identification and treatment of those who are underweight and a critical follow-up to the time of sputum culture conversion could help in further improving the outcomes.
结核病治疗中耐药性的出现是对公共卫生的重大威胁。然而，针对确定导致治疗目标差距的因素的研究有限。
本研究旨在评估2014年1月至2018年12月在迪尔乔拉医院治疗启动中心的耐多药/利福平耐药结核病（MDR/RR-TB）患者的治疗结果及其相关因素。
对2014年1月至2018年12月开始治疗的MDR/RR-TB患者进行回顾性横断面研究。使用结构化问卷从患者病历中提取数据。采用SPSS 26版进行分析。报告采用百分比和频数呈现。使用二元逻辑回归模型确定不良结局的独立相关因素。采用调整后的和粗略的比值比及95%置信区间。P值小于0.05表示具有统计学意义。
本研究共纳入146例患者。在本研究中，已知结局患者的总体不良结局患病率为8.6%。与HIV阴性者相比，HIV感染者死亡几率增加6.47倍（95%CI：1.14 - 36.68）。与BMI每降低1kg/m²者相比，BMI每增加1kg/m，死亡几率降低35.3%（调整后比值比 = 0.647；CI：0.44 - 0.95）。每增加一个月未实现痰菌转阴，死亡几率也增加2.24倍（95%CI：1.08 - 4.66）。
我们的研究结果表明该门诊项目的不良治疗结局明显较低。HIV筛查及早期启动高效抗逆转录病毒治疗（HAART）、对体重过轻者的早期识别和治疗以及对痰菌转阴时间的严格随访可能有助于进一步改善结局。
