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肺结核治疗失败:危险因素有哪些?一项综合性文献综述。

Tuberculosis treatment failure: what are the risk factors? A comprehensive literature review.

作者信息

Kėvelaitienė Karolina, Davidavičienė Valerija Edita, Danila Edvardas

机构信息

1 Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Vilnius University Faculty of Medicine, Vilnius, Lithuania; 2 Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.

Programs and Tuberculosis State Information System Department, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.

出版信息

Multidiscip Respir Med. 2025 Jul 4;20(1):1030. doi: 10.5826/mrm.2025.1030.

Abstract

Tuberculosis (TB), induced by Mycobacterium tuberculosis, is a significant global health concern. It affects approximately 25% of the global population and ranks among the primary causes of mortality from infectious diseases. Notwithstanding progress, TB treatment and diagnosis continue to encounter substantial obstacles, such as restricted access to precise diagnostics and efficacious therapies. By 2035, international objectives seek to diminish tuberculosis-related fatalities by 95% and enhance treatment accessibility. Multiple factors affect the success of TB treatment, including personal behaviors, social and demographic circumstances, and concurrent health conditions. Critical risk factors for suboptimal treatment outcomes encompass low body mass index, tobacco use, substance abuse, and various demographic variables, including gender, age, unemployment, geographic location, and migration status. Co-infections with HIV, diabetes, chronic kidney disease, and COVID-19 are associated with increased rates of treatment failure. Supplementary challenges, including loss to follow-up and drug-resistant TB, elevate the probability of treatment failure. This review's findings intend to furnish essential insights for policymakers, healthcare professionals, and TB control programs, enhancing strategies and interventions. The primary objective is to improve the efficacy of TB management globally, with an emphasis on attaining superior treatment outcomes, particularly in the most underserved regions.

摘要

由结核分枝杆菌引起的结核病是全球重大的健康问题。它影响着约25%的全球人口,是传染病致死的主要原因之一。尽管取得了进展,但结核病的治疗和诊断仍面临重大障碍,如难以获得精准诊断和有效治疗。到2035年,国际目标旨在将结核病相关死亡人数减少95%,并提高治疗可及性。多种因素影响结核病治疗的成功,包括个人行为、社会和人口状况以及并发健康状况。治疗效果欠佳的关键风险因素包括低体重指数、吸烟、药物滥用以及各种人口统计学变量,如性别、年龄、失业、地理位置和移民身份。与艾滋病毒、糖尿病、慢性肾脏病和新冠病毒的合并感染与治疗失败率增加有关。其他挑战,包括失访和耐药结核病,增加了治疗失败的可能性。本综述的研究结果旨在为政策制定者、医疗保健专业人员和结核病控制项目提供重要见解,以改进策略和干预措施。主要目标是提高全球结核病管理的成效,重点是取得更好的治疗效果,特别是在服务最欠缺的地区。

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