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印度拉贾斯坦邦一家三级护理医院中 COVID-19 大流行对结核病住院模式的影响:一项回顾性分析

Burden of COVID-19 pandemic on tuberculosis hospitalisation patterns at a tertiary care hospital in Rajasthan, India: a retrospective analysis.

作者信息

Rajotiya Sumit, Mishra Shivang, Singh Anurag Kumar, Debnath Sourav, Raj Preeti, Singh Pratima, Bareth Hemant, Nakash Prashant, Sharma Anupama, Singh Mahaveer, Nathiya Deepak, Joshi Nalin, Tomar Balvir Singh

机构信息

Department of Pharmacy Practice, NIMS University, Jaipur, Rajasthan, India.

Department of Public health, School of Health Sciences, University of Manchester, Manchester, UK.

出版信息

BMJ Open. 2024 May 3;14(5):e080623. doi: 10.1136/bmjopen-2023-080623.

Abstract

OBJECTIVE

This study aimed to investigate the burden of the COVID-19 pandemic on tuberculosis (TB) trends, patient demographics, disease types and hospitalisation duration within the Respiratory Medicine Department over three distinct phases: pre-COVID-19, COVID-19 and post-COVID-19.

DESIGN

Retrospective analysis using electronic medical records of patients with TB admitted between June 2018 and June 2023 was done to explore the impact of COVID-19 on patients with TB. The study employed a meticulous segmentation into pre-COVID-19, COVID-19 and post-COVID-19 eras.

SETTING

National Institute of Medical Science Hospital in Jaipur, Rajasthan, India.

PRIMARY AND SECONDARY OUTCOME MEASURES

Primary outcome includes patients admitted to the Respiratory Medicine Department of the hospital and secondary outcome involves the duration of hospital stay.

RESULTS

The study encompassed 1845 subjects across the three eras, revealing a reduction in TB incidence during the post-COVID-19 era compared with the pre-COVID-19 period (p<0.01). Substantial demographic shifts were observed, with 5.2% decline in TB incidence among males in the post-COVID-19 era (n=529) compared with the pre-COVID-19 era (n=606). Despite the decrease, overall TB incidence remained significantly higher in males (n=1460) than females (n=385), with consistently elevated rates in rural (65.8%) as compared with the urban areas (34.2%). Extended hospital stays were noted in the post-COVID-19 era compared with the pre-COVID-19 era (p<0.01).

CONCLUSION

The study underscores the influence of the COVID-19 pandemic on the TB landscape and hospitalisation dynamics. Notably, patient burden of TB declined during the COVID-19 era, with a decline in the post-COVID-19 era compared with the pre-COVID-19 era. Prolonged hospitalisation in the post-COVID-19 period indicates the need for adaptive healthcare strategies and the formulation of public health policies in a post-pandemic context. These findings contribute to a comprehensive understanding of the evolving TB scenario, emphasising the necessity for tailored healthcare approaches in the aftermath of a global health crisis.

摘要

目的

本研究旨在调查2019冠状病毒病大流行对呼吸内科结核病(TB)趋势、患者人口统计学特征、疾病类型和住院时间的影响,分为三个不同阶段:2019冠状病毒病之前、2019冠状病毒病期间和2019冠状病毒病之后。

设计

利用2018年6月至2023年6月期间收治的结核病患者的电子病历进行回顾性分析,以探讨2019冠状病毒病对结核病患者的影响。该研究对2019冠状病毒病之前、2019冠状病毒病期间和2019冠状病毒病之后的时期进行了细致划分。

背景

印度拉贾斯坦邦斋浦尔的国家医学科学研究所医院。

主要和次要观察指标

主要观察指标包括入住该医院呼吸内科的患者,次要观察指标涉及住院时间。

结果

该研究涵盖了三个时期的1845名受试者,结果显示2019冠状病毒病之后时期的结核病发病率与2019冠状病毒病之前时期相比有所下降(p<0.01)。观察到显著的人口统计学变化,2019冠状病毒病之后时期男性结核病发病率(n=529)与2019冠状病毒病之前时期(n=606)相比下降了5.2%。尽管有所下降,但男性(n=1460)的总体结核病发病率仍显著高于女性(n=385),农村地区(65.8%)的发病率始终高于城市地区(34.2%)。与2019冠状病毒病之前时期相比,2019冠状病毒病之后时期的住院时间延长(p<0.01)。

结论

该研究强调了2019冠状病毒病大流行对结核病格局和住院动态的影响。值得注意的是,2019冠状病毒病期间结核病患者负担下降,2019冠状病毒病之后时期与2019冠状病毒病之前时期相比也有所下降。2019冠状病毒病之后时期住院时间延长表明,在大流行后背景下需要适应性医疗策略并制定公共卫生政策。这些发现有助于全面了解不断演变的结核病情况,强调在全球健康危机之后采取针对性医疗方法的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4e3/11086464/ec5dbb283557/bmjopen-2023-080623f01.jpg

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