加纳结核病/艾滋病病毒合并感染患者结核病治疗结果未成功的患病率及预测因素：一项10年回顾性研究

Prevalence and predictors of unsuccessful tuberculosis treatment outcomes among persons with TB/HIV co-infection in Ghana: a 10-year retrospective study.

作者信息

Cobbinah Alhaji Ibrahim, Idan Jacob Solomon, Boakye Kingsley, Enimil Anthony, Mensah Nicholas Karikari, Adangabe Ebenezer, Abdulai Sulemana Baba, Martyn-Dickens Charles, Mohammed Aliyu

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

University Health Services, University of Education, Winneba, Ghana.

出版信息

BMC Infect Dis. 2025 May 6;25(1):669. doi: 10.1186/s12879-025-11054-7.

DOI:10.1186/s12879-025-11054-7

PMID:40329215

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12057233/

Abstract

INTRODUCTION

Unsuccessful treatment outcomes significantly impact tuberculosis control efforts globally particularly among individuals co-infected with Human Immunodeficiency Virus (HIV). This study aimed to assess the prevalence, trends, and associated factors of unsuccessful Tuberculosis (TB) treatment outcomes among persons with TB/HIV co-infection at Komfo Anokye Teaching Hospital in Ghana over a 10-year period.

METHODS

A retrospective cross-sectional study was conducted using data from the Komfo Anokye Teaching Hospital between January 2012 and December 2022. A total of 1,242 persons with TB/HIV co-infection were included in the study. Unsuccessful treatment outcomes were defined as death, treatment failure, or default. Modified Poisson regression with robust standard errors was performed using Stata version 17.0 to identify predictors of unsuccessful outcomes. Crude and adjusted relative risk ratios with 95% confidence intervals (CI) were reported, and a p-value < 0.05 was considered statistically significant.

RESULTS

The prevalence of unsuccessful treatment outcomes for the 10-year period was 24.6% (95% CI: 22.3-27.1). The analysis revealed a decreasing trend of unsuccessful TB treatment outcomes from 47.6% in 2012 to 7.79 in 2022. In the multivariable analysis, older age (≥ 65 years) was associated with a higher risk of unsuccessful outcomes (ARR: 5.6, 95% CI: 2.8-11.1). Conversely, pretreatment weights of 40-54 kg (ARR: 0.5, 95% CI: 0.3-0.7), 55-69 kg (ARR: 0.4, 95% CI: 0.3-0.6), and ≥ 74 kg (ARR: 0.2, 95% CI: 0.1-0.7) were associated with reduced risk. The presence of a treatment supporter also lowered the risk of unsuccessful outcomes (ARR: 0.8, 95% CI: 0.6-0.9).

CONCLUSION

The high prevalence of unsuccessful TB treatment outcomes among persons with TB/HIV co-infection within the 10-year period highlights the need for targeted interventions. Prioritizing care for older patients, improving nutritional support, and promoting treatment supporter involvement will enhance treatment success in Ghana.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

引言

治疗效果不佳对全球结核病防控工作产生重大影响，在合并感染人类免疫缺陷病毒（HIV）的个体中尤为如此。本研究旨在评估加纳Komfo Anokye教学医院10年间结核病/艾滋病病毒合并感染患者治疗效果不佳的患病率、趋势及相关因素。

方法

采用Komfo Anokye教学医院2012年1月至2022年12月的数据进行回顾性横断面研究。共有1242例结核病/艾滋病病毒合并感染患者纳入研究。治疗效果不佳定义为死亡、治疗失败或失访。使用Stata 17.0软件进行稳健标准误的修正泊松回归，以确定治疗效果不佳的预测因素。报告粗相对风险率和调整后的相对风险率及95%置信区间（CI），p值<0.05被认为具有统计学意义。