Bandim Health Project, INDEPTH Network, Apartado 861, Bissau, Guinea-Bissau.
Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
Int J Epidemiol. 2023 Aug 2;52(4):1112-1123. doi: 10.1093/ije/dyad039.
Few studies have assessed life expectancy of patients with tuberculosis (TB) against a comparable background population, particularly in low-income, high-incidence settings. This study aimed to estimate the life expectancy (LE) of patients with TB in the West African country of Guinea-Bissau and compare it with the LE of the background population.
This study used data from the Bandim TB cohort from 2004-20 as well as census data from the capital of Guinea-Bissau. LE was estimated using a bootstrapped Kaplan-Meier survival analysis for patients with TB and the background population, stratifying by age of entry and various patient subgroups. The analysis was further stratified by diagnosis period and length of schooling (an indicator of socioeconomic status), to assess their influence on LE. A sensitivity analysis was performed assuming death at loss to follow-up.
The analysis included 2278 patients and a background population of 169 760 individuals. Overall median LE among 30-year-old patients with TB was 10.7 years (95% CI: 8.7-12.6), compared with 35.8 (95% CI: 35.1-36.5) in the background population. LE was shorter in HIV-infected patients and those who had unsuccessful treatment outcome; however, even among those who were both uninfected with HIV and experienced successful treatment outcome, LE was 20% shorter than in the background population. Longer schooling appeared to decrease mortality.
TB substantially shortens LE. This effect is present even in patients who are uninfected with HIV and who have successful treatment outcome.
很少有研究评估过结核病（TB）患者与可比背景人群的预期寿命，尤其是在低收入、高发病率的环境中。本研究旨在估计几内亚比绍西非国家的结核病患者的预期寿命（LE），并将其与背景人群的 LE 进行比较。
本研究使用了 2004-20 年班丁姆结核病队列的数据以及几内亚比绍首都的人口普查数据。使用 bootstrap Kaplan-Meier 生存分析对结核病患者和背景人群进行 LE 估计，按进入年龄和各种患者亚组分层。进一步按诊断期和受教育程度（社会经济地位的一个指标）分层，以评估它们对 LE 的影响。假设失访时死亡，进行敏感性分析。
该分析包括 2278 名患者和 169760 名背景人群。30 岁结核病患者的总体中位 LE 为 10.7 年（95%CI：8.7-12.6），而背景人群为 35.8 年（95%CI：35.1-36.5）。在 HIV 感染患者和治疗结果不成功的患者中，LE 更短；然而，即使在既未感染 HIV 又经历成功治疗结果的患者中，LE 也比背景人群短 20%。较长的受教育程度似乎降低了死亡率。
结核病大大缩短了 LE。即使在未感染 HIV 且治疗结果成功的患者中，这种影响仍然存在。
