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安哥拉罗安达疗养院医院结核病治疗期间失访的相关危险因素。

Risk Factors Associated with Loss to Follow-Up during Tuberculosis Treatment in the Sanatorium Hospital of Luanda, Angola.

作者信息

Vita Domingos, Aznar Maria Luisa, Martínez-Campreciós Joan, Kansietoko Debora Cristina Maindo Sebastiao, Molina Israel

机构信息

DSS/EMG/FAA-Angola, Vita International Health Agency, London SW8 4EP, UK.

Department of Engineering and Technology, Instituto Superior Politécnico de Tecnologias e Ciências (ISPTEC), Luanda 2850, Angola.

出版信息

Trop Med Infect Dis. 2024 Jun 12;9(6):131. doi: 10.3390/tropicalmed9060131.

Abstract

BACKGROUND

Tuberculosis (TB) continues to be a serious public health threat that affects the most vulnerable populations. Patients who are lost to follow-up (LTFU) after TB diagnosis still represent one of the biggest challenges to TB control.

METHOD

In this prospective observational study, we aimed to identify and analyse the risk factors associated with LTFU among TB patients who started first-line TB treatment in the Sanatorium Hospital in Luanda.

RESULT

A total of 113 patients with TB (non-multidrug resistant) were included between August 2018 and September 2019. Seventy-six (67.3%) patients were cured, 27 (23.9%) were LTFU, 5 (4.4%) died, 4 (3.5%) were transferred and 1 (0.9%) presented treatment failure. After excluding those who died, were transferred or failed treatment, we observed that severe TB at the time of diagnosis (OR 9.24, 95% CI 2.18-39.04) and food insecurity were significantly associated with LTFU (OR 5.96, 95% CI 1.66-21.41).

CONCLUSIONS

The findings of our study can contribute to understanding the reasons for the LTFU of patients with TB and can guide policies and facilitate designing measures to allow better adherence and, therefore, greater treatment success.

摘要

背景

结核病仍然是一种严重的公共卫生威胁,影响着最脆弱的人群。结核病诊断后失访的患者仍是结核病控制面临的最大挑战之一。

方法

在这项前瞻性观察研究中,我们旨在识别和分析在罗安达疗养院开始一线抗结核治疗的结核病患者中与失访相关的危险因素。

结果

2018年8月至2019年9月期间共纳入113例非耐多药结核病患者。76例(67.3%)患者治愈,27例(23.9%)失访,5例(4.4%)死亡,4例(3.5%)转诊,1例(0.9%)治疗失败。排除死亡、转诊或治疗失败的患者后,我们观察到诊断时的重症结核病(比值比9.24,95%置信区间2.18 - 39.04)和粮食不安全与失访显著相关(比值比5.96,95%置信区间1.66 - 21.41)。

结论

我们的研究结果有助于理解结核病患者失访的原因,并可为政策制定提供指导,便于设计措施以提高依从性,从而提高治疗成功率。

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