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卢旺达结核病/艾滋病合并感染患者的结核病治疗及与治疗结果不佳相关的因素:一项回顾性队列研究

Tuberculosis Treatment and Factors Associated with Unsuccessful Tuberculosis Treatment Outcome among TB/HIV co-infected Patients in Rwanda: A Retrospective Cohort Study.

作者信息

Ruseesa Edward, Simbi Clarisse Marie Claudine, Ntaganira Joseph

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.

出版信息

Rwanda J Med Health Sci. 2023 Mar 28;6(1):17-26. doi: 10.4314/rjmhs.v6i1.3. eCollection 2023 Mar.

Abstract

INTRODUCTION

Mycobacterium tuberculosis remains the main cause of death as an infectious agent of Tuberculosis in humans, particularly in resource-poor settings. Worldwide, Tuberculosis is one of the top 10 causes of mortality.

OBJECTIVE OF THE STUDY

This study aims to determine the outcomes of TB treatment and assess the factors associated with unsuccessful TB treatment outcome among TB/HIV co-infected patients in Rwanda.

METHODS

This was a retrospective cohort study of all TB/HIV co-infected patients reported in the national electronic TB reporting system (e-TB) by all health facilities from July 2019 to June 2020. Frequencies, proportions, bivariate and multivariate logistic regression were performed to determine factors associated with unsuccessful TB treatment.

RESULTS

There were 1,144 people reported in the e-TB, however, only 987 were included in the study because 157 patients did not meet the inclusion criteria.The TB/HIV co-infected patients who were not given nutritional support, OR 7.3, 95%CI [1.4, 37.6] and those who were not on ART,OR15.3, 95%CI [3.6, 69.6],were more likely to have unsuccessful treatment outcome than their counterparts.

CONCLUSION

Unsuccessful TB treatment outcomes were highly observed among TB/HIV co-infected patients. The study recommended reinforcing nutritional support and early initiation of ART among TB/HIV co-infected patients.

摘要

引言

结核分枝杆菌仍然是人类结核病的主要致死病原体,尤其是在资源匮乏地区。在全球范围内,结核病是十大死因之一。

研究目的

本研究旨在确定卢旺达结核病/艾滋病病毒合并感染患者的结核病治疗结果,并评估与结核病治疗结果不佳相关的因素。

方法

这是一项回顾性队列研究,研究对象为2019年7月至2020年6月期间所有卫生机构在国家电子结核病报告系统(e-TB)中报告的所有结核病/艾滋病病毒合并感染患者。进行频率、比例、双变量和多变量逻辑回归分析以确定与结核病治疗失败相关的因素。

结果

e-TB报告了1144人,但只有987人纳入研究,因为157名患者不符合纳入标准。未接受营养支持的结核病/艾滋病病毒合并感染患者,比值比为7.3,95%置信区间[1.4, 37.6];未接受抗逆转录病毒治疗的患者,比值比为15.3,95%置信区间[3.6, 69.6],他们治疗结果不佳的可能性高于接受相应治疗的患者。

结论

在结核病/艾滋病病毒合并感染患者中,结核病治疗失败的情况很常见。该研究建议加强对结核病/艾滋病病毒合并感染患者的营养支持,并尽早开始抗逆转录病毒治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8499/12110472/8bb97022e835/RJMHS0601-0017Fig1.jpg

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