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摩洛哥得土安患者活动性肺结核的纵向前瞻性研究。

A Longitudinal Prospective Study of Active Tuberculosis Among Patients in Tétouan, Morocco.

作者信息

Ez-Zari Ayoub, Farouk Laila, Vilaplana Cristina, Mezzoug Nadya, Bouti Khalid, El Mtili Noureddine

机构信息

Department of Biology, Laboratory of Biology and Health, Food Science and Health Research Team (UAE/U06FS) Faculty of Science, Abdelmalek Essaâdi University, Tétouan, MAR.

Department of Pulmonology, Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute and Hospital, Barcelona, ESP.

出版信息

Cureus. 2025 Apr 7;17(4):e81838. doi: 10.7759/cureus.81838. eCollection 2025 Apr.

Abstract

BACKGROUND

Tuberculosis (TB) continues to be a significant global health challenge, particularly in developing countries. Tétouan, Morocco, is among the most affected cities in the country; however, limited information is available on the impact of TB and its treatment on various aspects of patients' lives. This study aims to comprehensively analyze the clinical, microbiological, nutritional, and psychosocial characteristics of patients undergoing intensive pulmonary TB treatment in Tétouan.

METHODS

We conducted a 1.5-year prospective study on patients with bacteriologically confirmed pulmonary TB during the intensive treatment phase. Clinical, social, psychological, and nutritional data were collected, and bacteriological monitoring was performed. Statistical analysis was conducted using SPSS software (IBM Corp., Armonk, NY), with a 95% significance level.

RESULTS

Among the 125 surveyed patients (mean age: 37.5 years, male-to-female ratio: 3.8), 91 (73.2%) resided in urban areas, 19 (15.4%) had difficulties reaching a healthcare center, and 89 (71%) were newly diagnosed. Side effects were reported by 121 patients (97%), primarily muscle and joint pain. A balanced diet was maintained by 80 patients (63.9%) during treatment. Anxiety was observed in 102 patients (82%) and correlated with female gender, retreatment cases, smoking, side effects, and living in urban areas. Depression was experienced by 113 patients (91%), significantly associated with smoking, side effects, and retreatment cases. The sputum conversion rate was low (62.4%) and showed a significant correlation with symptom progression after two months of intensive treatment.

CONCLUSION

Consistent patient support throughout the entire treatment period is crucial to preventing dropout and treatment failure. Greater efforts are needed to strengthen economic, social, and psychological support for patients. Healthcare educational units play a key role in informing patients about nutrition, potential side effects, and nicotine withdrawal symptoms. These interventions are essential to enhancing adherence and improving overall treatment outcomes in Tétouan.

摘要

背景

结核病仍然是一项重大的全球卫生挑战,在发展中国家尤为如此。摩洛哥的得土安是该国受影响最严重的城市之一;然而,关于结核病及其治疗对患者生活各个方面的影响,现有信息有限。本研究旨在全面分析在得土安接受强化肺结核治疗的患者的临床、微生物学、营养和社会心理特征。

方法

我们对强化治疗阶段细菌学确诊的肺结核患者进行了为期1.5年的前瞻性研究。收集了临床、社会、心理和营养数据,并进行了细菌学监测。使用SPSS软件(IBM公司,纽约州阿蒙克)进行统计分析,显著性水平为95%。

结果

在125名接受调查的患者中(平均年龄:37.5岁,男女比例:3.8),91名(73.2%)居住在城市地区,19名(15.4%)前往医疗中心有困难,89名(71%)为新诊断患者。121名患者(97%)报告有副作用,主要是肌肉和关节疼痛。80名患者(63.9%)在治疗期间保持了均衡饮食。102名患者(82%)存在焦虑,且与女性性别、复治病例、吸烟、副作用和居住在城市地区有关。113名患者(91%)有抑郁情绪,与吸烟、副作用和复治病例显著相关。痰菌转阴率较低(62.4%),且与强化治疗两个月后的症状进展显著相关。

结论

在整个治疗期间持续为患者提供支持对于预防治疗中断和治疗失败至关重要。需要加大力度加强对患者的经济、社会和心理支持。医疗卫生教育单位在告知患者营养、潜在副作用和尼古丁戒断症状方面发挥着关键作用。这些干预措施对于提高得土安患者的依从性和改善总体治疗效果至关重要。

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