Rameli N A C, Yaacob S S, Ismail N, Azzani M, Harishah T
Universiti Teknologi MARA, Faculty of Medicine, Department of Public Health Medicine, Sungai Buloh, Selangor, Malaysia.
Tuberculosis/Leprosy Unit, Selangor State Health Department, Malaysia.
Med J Malaysia. 2025 Jan;80(1):9-16.
Despite the availability of highly effective treatment for tuberculosis (TB), patients with TB may experience a relapse, which can be either a result of the disease reactivating or a new episode induced by reinfection. In Malaysia, there has been a noticeable rise in relapse TB cases, with a substantial rate of unsuccessful treatment outcomes among this population. This study seeks to examine the trends of unsuccessful treatment outcomes in relapse TB patients and explore how factors such as sociodemographic characteristics, TB disease profile, TB treatment profile, and comorbidities contribute to the outcomes.
This is a retrospective cohort study utilising secondary data from the National Tuberculosis Registry (NTBR). The study was conducted in Selangor among relapsed TB patients who were registered in NTBR from 1 January 2015 to 31 December 2019. TB disease profile, TB treatment profile, comorbidities, and sociodemographic data were examined. The determinants of unsuccessful treatment outcomes among relapsed TB patients were identified using multiple (binary) logistic regression analyses.
896 patients who experienced relapsed tuberculosis were included in this study. 32.25% were reported to have unsuccessful treatment outcomes. Multiple (binary) logistic regression revealed that the absence of sputum smear examination at 5 months and beyond was a determinant of unsuccessful treatment outcome (AOR 1.70 (95% CI: 1.19, 2.44). Additionally, being treated in government facilities, such as government hospitals and government primary health clinics, was a protective factor (AOR 0.06 (95% CI: 0.03, 0.15) and AOR 0.02 (95% CI: 0.01, 0.04), respectively.
The high proportion of unsuccessful treatment outcomes among relapse TB patients stresses the importance of adherence to routine sputum monitoring and public-private partnerships.
尽管有针对结核病（TB）的高效治疗方法，但结核病患者仍可能复发，这可能是疾病重新激活的结果，也可能是再次感染引发的新发病例。在马来西亚，复发性结核病病例显著增加，这部分人群的治疗结果未成功的比例相当高。本研究旨在探讨复发性结核病患者治疗结果未成功的趋势，并探究社会人口学特征、结核病疾病概况、结核病治疗概况和合并症等因素如何影响治疗结果。
这是一项回顾性队列研究，利用国家结核病登记处（NTBR）的二手数据。该研究在雪兰莪州对2015年1月1日至2019年12月31日在NTBR登记的复发性结核病患者进行。检查了结核病疾病概况、结核病治疗概况、合并症和社会人口学数据。使用多重（二元）逻辑回归分析确定复发性结核病患者治疗结果未成功的决定因素。
本研究纳入了896例经历复发性结核病的患者。据报告，32.25%的患者治疗结果未成功。多重（二元）逻辑回归显示第5个月及以后未进行痰涂片检查是治疗结果未成功的一个决定因素（调整后比值比1.70（95%置信区间：1.19，2.44）。此外，在政府设施（如政府医院和政府初级保健诊所）接受治疗是一个保护因素（调整后比值比分别为0.06（95%置信区间：0.03，0.15）和0.02（95%置信区间：0.01，0.04）。
复发性结核病患者中治疗结果未成功的比例很高，这凸显了坚持常规痰监测和公私伙伴关系的重要性。
