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印度南部的结核病治疗结果和患者支持团体。

Tuberculosis treatment outcomes and patient support groups, southern India.

机构信息

Karnataka Health Promotion Trust (KHPT), IT Park, Rajajinagar Industrial Area, Behind KSSIDC Administration Office, Rajajinagar, Bengaluru, Karnataka, India560044.

Office of the Joint Director, Lady Willingdon State TB Centre, Bengaluru, India.

出版信息

Bull World Health Organ. 2023 Jan 1;101(1):28-35A. doi: 10.2471/BLT.22.288237. Epub 2022 Nov 15.

Abstract

OBJECTIVE

To assess treatment outcomes in tuberculosis patients participating in support group meetings in five districts of Karnataka and Telangana states in southern India.

METHODS

Tuberculosis patients from five selected districts who began treatment in 2019 were offered regular monthly support group meetings, with a focus on patients in urban slum areas with risk factors for adverse outcomes. We tracked the patients' participation in these meetings and extracted treatment outcomes from the Nikshay national tuberculosis database for the same patients in 2021. We compared treatment outcomes based on attendance of the support groups meetings.

FINDINGS

Of 30 706 tuberculosis patients who started treatment in 2019, 3651 (11.9%) attended support groups meetings. Of patients who attended at least one support meeting, 94.1% (3426/3639) had successful treatment outcomes versus 88.2% (23 745/26 922) of patients who did not attend meetings (adjusted odds ratio, aOR: 2.44; 95% confidence interval, CI: 2.10-2.82). The odds of successful treatment outcomes were higher in meeting participants than non-participants for all variables examined including: age ≥ 60 years (aOR: 3.19; 95% CI: 2.26-4.51); female sex (aOR: 3.33; 95% CI: 2.46-4.50); diabetes comorbidity (aOR: 3.03; 95% CI: 1.91-4.81); human immunodeficiency virus infection (aOR: 3.73; 95% CI: 1.76-7.93); tuberculosis retreatment (aOR: 1.69; 1.22-2.33); and drug-resistant tuberculosis (aOR: 1.93; 95% CI: 1.21-3.09).

CONCLUSION

Participation in support groups for tuberculosis patients was significantly associated with successful tuberculosis treatment outcomes, especially among high-risk groups. Expanding access to support groups could improve tuberculosis treatment outcomes at the population level.

摘要

目的

评估在印度南部卡纳塔克邦和特伦甘纳邦的五个区参加支持小组会议的结核病患者的治疗结果。

方法

2019 年开始治疗的来自五个选定区的结核病患者被提供定期的每月支持小组会议,重点关注城市贫民窟地区有不良结果风险因素的患者。我们跟踪患者参加这些会议的情况,并从 Nikshay 国家结核病数据库中提取同一患者 2021 年的治疗结果。我们根据参加支持小组会议的情况比较治疗结果。

结果

在 2019 年开始治疗的 30706 名结核病患者中,有 3651 名(11.9%)参加了支持小组会议。在至少参加一次支持会议的患者中,94.1%(3426/3639)的治疗结果成功,而未参加会议的患者为 88.2%(23745/26922)(调整后的优势比,aOR:2.44;95%置信区间,CI:2.10-2.82)。在所有检查的变量中,与未参加会议的患者相比,参加会议的患者的治疗结果成功的可能性更高,包括:年龄≥60 岁(aOR:3.19;95% CI:2.26-4.51);女性(aOR:3.33;95% CI:2.46-4.50);糖尿病合并症(aOR:3.03;95% CI:1.91-4.81);人类免疫缺陷病毒感染(aOR:3.73;95% CI:1.76-7.93);结核病复发(aOR:1.69;1.22-2.33);和耐多药结核病(aOR:1.93;95% CI:1.21-3.09)。

结论

参加结核病患者支持小组与结核病治疗结果成功显著相关,特别是在高风险群体中。扩大支持小组的获取途径可以提高人群层面的结核病治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc4a/9795383/e084bc478b4a/BLT.22.288237-F1.jpg

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