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加纳成年结核病确诊患者治疗结果评估:一项10年回顾性研究。

Evaluation of treatment outcomes among adult patients diagnosed with tuberculosis in Ghana: A 10 year retrospective review.

作者信息

Puplampu Peter, Kyeremateng Isaac, Asafu-Adjaye Olive, Asare Anita Ago, Agyabeng Kofi, Sarkodee Roderick, Oluwakemi Oladele, Ganu Vincent

机构信息

Department of Medicine & Therapeutics, University of Ghana Medical School, Accra, Ghana.

Infectious disease unit, Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana.

出版信息

IJID Reg. 2023 Nov 10;10:9-14. doi: 10.1016/j.ijregi.2023.11.004. eCollection 2024 Mar.

Abstract

OBJECTIVES

The study determined tuberculosis (TB) treatment outcomes in Southern Ghana from 2012 to 2021.

METHODS

A retrospective analysis of service data on TB cases was conducted. Treatment success was defined as TB cure or completion of treatment course, whereas unsuccessful outcomes was defined as death, failure of treatment and lost to follow up. Bivariate and multivariate logistic regression was used to determine factors associated with treatment outcomes.

RESULTS

A total of 4106 adult TB cases were reported with a median age of 41 (interquartile range 32-52) years. Of these, 93.1% (n = 3823) were newly diagnosed. The treatment success rate declined from 71.0% in 2012 to 55.7% in 2021 (ktau-b = -0.56,  = 0.0318). Clinically diagnosed TB and extra-pulmonary TB had 7.0% (adjusted prevalence ratio [aPR]: 0.93, 95% confidence interval [CI]: 0.88-1.00) and 24.0% (aPR: 0.76, 95% CI: 0.69-0.84) respectively, less successful treatment outcome compared to pulmonary TB patients. HIV negative status was associated with 22% higher successful treatment outcome compared with being HIV positive (aPR: 1.22, 95% CI: 1.12-1.33).

CONCLUSION

Tuberculosis treatment success rate declined over the period. There is a need for the TB Control Programme to review the national and sub-national TB data to ascertain poor performing TB treatment sites to identify and address context specific challenges with treatment interventions and system inadequacies to improve treatment success rates.

摘要

目的

本研究确定了2012年至2021年加纳南部的结核病治疗结果。

方法

对结核病病例的服务数据进行回顾性分析。治疗成功定义为结核病治愈或完成治疗疗程,而治疗失败定义为死亡、治疗失败和失访。采用双变量和多变量逻辑回归来确定与治疗结果相关的因素。

结果

共报告了4106例成人结核病病例,中位年龄为41岁(四分位间距32 - 52岁)。其中,93.1%(n = 3823)为新诊断病例。治疗成功率从2012年的71.0%下降到2021年的55.7%(ktau - b = -0.56,P = 0.0318)。与肺结核患者相比,临床诊断的结核病和肺外结核病的治疗成功率分别低7.0%(调整患病率比[aPR]:0.93,95%置信区间[CI]:0.88 - 1.00)和24.0%(aPR:0.76,95% CI:0.69 - 0.84)。与HIV阳性相比,HIV阴性状态的治疗成功率高22%(aPR:1.22,95% CI:1.12 - 1.33)。

结论

在此期间,结核病治疗成功率下降。结核病控制项目需要审查国家和国家以下层面的结核病数据,以确定结核病治疗效果不佳的地点,识别并应对治疗干预措施和系统不足方面的具体挑战,以提高治疗成功率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ce1/10687693/ab5d3ae98397/gr1.jpg

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