Anaam Mohammed Saif, Alrasheedy Alian A
Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Qassim 51911, Saudi Arabia.
Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah 51452, Saudi Arabia.
Trop Med Infect Dis. 2023 Feb 10;8(2):110. doi: 10.3390/tropicalmed8020110.
Tuberculosis (TB) recurrence following successful treatment is a significant challenge in TB control programs. However, the rate of TB recurrence varies among studies. It depends on several factors, including the country/region where the investigation occurs, the study design, sample characteristics, and the anti-TB regimen used. In Yemen, a few previous studies examined the rate of TB recurrence and reported high recurrence rates, with a 5-year recurrence rate of approximately 9.5%. However, they were conducted before 2010 using the previous anti-TB regimen which was phased out and replaced with the World Health Organization's (WHO) standard 6-month TB regimen. Consequently, this study aimed to examine the rate of TB recurrence after the implementation of the WHO standard 6-month regimen in Yemen. A prospective observational study was conducted with patients diagnosed with drug-susceptible pulmonary TB. The patients were recruited from five health centers with TB units in five governorates from January to December 2011. All the patients were followed up for five years after treatment completion. A total of 439 patients who completed the anti-TB regimen met the inclusion criteria and were included in the study. During the 5-year follow-up period, 8 patients (1.8%) died, and 13 patients (2.96%) were lost to follow-up, resulting in a final cohort of 418 patients. Of the cohort, 50.5% (n = 211) were male, while 49.5% (n = 207) were female patients. Of the patients, 129 patients (30.9%) were illiterate, 56 (13.4%) had cavitary pulmonary disease, and 6.2% (n = 26) had diabetes. The overall 5-year rate of TB recurrence in this study for the patients receiving the standard 6-month regimen was 2.9% (12/418). Moreover, almost half of the recurrent cases (41.7%; n = 5) were seen during the first year of the follow-up period. Some patient groups with risk factors recorded a higher recurrence rate, including patients with diabetes (15.4%), non-compliant patients (14.3%), pre-treatment lung cavitation patients (8.9%), illiterate patients (7.8%), and underweight patients (5.1%). In conclusion, the overall TB recurrence rate with the standard 6-month regimen was lower than that with the previous TB regimens. However, more efforts are needed to decrease TB recurrence rates further and achieve a durable cure for TB. In addition, healthcare professionals and TB control programs should consider potential risk factors of recurrence and address them to provide optimal care.
成功治疗后的结核病复发是结核病控制项目中的一项重大挑战。然而，不同研究中结核病的复发率有所不同。这取决于几个因素，包括开展调查的国家/地区、研究设计、样本特征以及所使用的抗结核治疗方案。在也门，之前有几项研究调查了结核病复发率，并报告了较高的复发率，5年复发率约为9.5%。然而，这些研究是在2010年之前使用已淘汰的旧抗结核治疗方案进行的，后来被世界卫生组织（WHO）的标准6个月结核病治疗方案所取代。因此，本研究旨在调查也门实施WHO标准6个月治疗方案后的结核病复发率。对诊断为药物敏感型肺结核的患者进行了一项前瞻性观察研究。这些患者于2011年1月至12月从五个省的五个设有结核病科室的卫生中心招募。所有患者在完成治疗后进行了五年的随访。共有439名完成抗结核治疗方案的患者符合纳入标准并被纳入研究。在5年的随访期内，8名患者（1.8%）死亡，13名患者（2.96%）失访，最终队列中有418名患者。在该队列中，50.5%（n = 211）为男性，49.5%（n = 207）为女性患者。在这些患者中，129名患者（30.9%）为文盲，56名（13.4%）有空洞性肺病，6.2%（n = 26）患有糖尿病。本研究中接受标准6个月治疗方案的患者5年结核病总体复发率为2.9%（12/418）。此外，几乎一半的复发病例（41.7%；n = 5）出现在随访期的第一年。一些有危险因素的患者组复发率较高，包括糖尿病患者（15.4%）、不依从患者（14.3%）、治疗前有肺部空洞的患者（8.9%）、文盲患者（7.8%）和体重过轻的患者（5.1%）。总之，标准6个月治疗方案的总体结核病复发率低于之前的抗结核治疗方案。然而，需要做出更多努力以进一步降低结核病复发率并实现结核病的持久治愈。此外，医疗保健专业人员和结核病控制项目应考虑复发的潜在危险因素并加以应对，以提供最佳护理。
