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东开普省部分乡村医院结核病患者的治疗结果及相关因素:一项双向研究

Treatment Outcomes and Associated Factors among Tuberculosis Patients from Selected Rural Eastern Cape Hospitals: An Ambidirectional Study.

作者信息

Faye Lindiwe M, Hosu Mojisola C, Iruedo Joshua, Vasaikar Sandeep, Nokoyo Kolisa A, Tsuro Urgent, Apalata Teke

机构信息

Department of Laboratory Medicine and Pathology, Walter Sisulu University and National Health Laboratory Services (NHLS), Private Bag X5117, Mthatha 5099, South Africa.

Department of Family Medicine, Walter Sisulu University, Private Bag X5117, Mthatha 5099, South Africa.

出版信息

Trop Med Infect Dis. 2023 Jun 9;8(6):315. doi: 10.3390/tropicalmed8060315.

Abstract

An essential metric for determining the efficacy of tuberculosis (TB) control programs is the evaluation of TB treatment outcomes; this study was conducted to investigate treatment outcomes and associated factors among tuberculosis patients in rural areas of Eastern Cape, South Africa. Assessing treatment outcomes is fundamental to facilitating the End TB Strategy's set target. Clinic records from 457 patients with DR-TB were examined for data collection while 101 patients were followed up prospectively. Data were analyzed using Stata version 17.0. The odds ratio and 95% confidence interval were calculated to check the association between variables. ≤ 0.05 was considered statistically significant. Of the 427 participants, 65.8% had successful treatment whilst 34.2% had unsuccessful TB treatment. A total of 61.2% and 39% of the HIV-positive and HIV-negative participants had a successful TB treatment whilst 66% and 34% of both HIV-negative and positive participants had unsuccessful TB treatment. From the 101 patients that were followed up, smokers took longer to have treatment outcomes compared to non-smokers. In the study with HIV/TB co-infection, men predominated. HIV and tuberculosis co-infection made therapy difficult with unfavorable effects on TB management. The treatment success rate (65.8%) was lower than the WHO threshold standard with a high proportion of patients being lost to the follow up. The co-infection of tuberculosis and HIV resulted in undesirable treatment outcomes. Strengthening TB surveillance and control is recommended.

摘要

确定结核病(TB)控制项目成效的一项关键指标是对结核病治疗结果的评估;本研究旨在调查南非东开普农村地区结核病患者的治疗结果及相关因素。评估治疗结果对于推动“终止结核病战略”设定的目标至关重要。研究检查了457例耐多药结核病患者的临床记录以收集数据,同时对101例患者进行了前瞻性随访。使用Stata 17.0版本对数据进行分析。计算优势比和95%置信区间以检验变量之间的关联。P≤0.05被认为具有统计学意义。在427名参与者中,65.8%的患者治疗成功,而34.2%的患者结核病治疗未成功。HIV阳性和HIV阴性参与者中分别有61.2%和39%的患者结核病治疗成功,而HIV阴性和阳性参与者中分别有66%和34%的患者结核病治疗未成功。在随访的101例患者中,吸烟者比不吸烟者达到治疗结果所需的时间更长。在HIV/TB合并感染的研究中,男性占主导。HIV与结核病合并感染使治疗变得困难,对结核病管理产生不利影响。治疗成功率(65.8%)低于世界卫生组织的阈值标准,且有很大比例的患者失访。结核病与HIV合并感染导致了不理想的治疗结果。建议加强结核病监测与控制。

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