Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years' Retrospective Aggregated Data.
Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years' Retrospective Aggregated Data.
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DOI：
10.3389/fmed.2018.00038
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发表时间：
2018
影响因子：
3.9
通讯作者：
Siu GKH
中科院分区：
文献类型：
--
作者：
Tafess K;Beyen TK;Abera A;Tasew G;Mekit S;Sisay S;Tadesse L;Siu GKH
短程直接观察治疗（DOTS）是全球抗击结核病流行的主要策略之一。本研究旨在评估2004年9月至2014年7月期间在埃塞俄比亚最大的公立医院之一实施DOTS计划的结核病治疗结果。从医院登记处获得了2004年9月至2014年7月在Asella教学医院登记的结核病患者的回顾性数据。根据国家结核病控制规划指南对结核病病例的治疗结果和类型进行分类。使用二项和多项逻辑回归模型分析治疗结果与潜在预测变量之间的相关性。共有1,755名结核病患者的记录被纳入研究。其中，945人（53.8%）为男性，480人（27.4%）为涂片阳性结核病，287人（16.4%）为艾滋病毒阳性，1 549人（88.3%）为新病例。480例涂阳肺结核病人治愈377例（78.5%），完成治疗21例（4.4%），转出35例（7.3%），死亡19例（4.0%），失治24例（5.0%），失败4例（0.8%）。总体而言，398例（82.9%）涂阳肺结核患者得到成功治疗。对于痰涂片阴性TB（n = 641）和肺外TB病例（n = 634），1，036例（81.3%）完成了治疗并显示出良好的反应。考虑到所有类型的结核病，1 434例（81.7%）被认为得到了成功治疗。在多变量二元logistic模型中，老年组（AOR = 0.386，95% CI：0.250-0.596）和复治病例（AOR = 0.422，95% CI：0.226-0.790）的患者成功治疗的可能性分别低于年轻和新病例。在多项Logistic回归分析中，年龄增加1岁使结核病患者的死亡和违约风险增加0.05（校正β = 0.05; 95%CI：0.03，0.06）和0.02（校正β = 0.02; 95%CI：0.01，0.04）。在HIV感染的结核病患者中，结核病患者在治疗期间死亡的几率较高（调整后的β = 2.65; 95% CI：1.28，5.50）。与国家目标相比，结核病患者的治疗成功率较低。需要加强结核病控制，以提高治疗效果。
Directly Observed Treatment Short-course (DOTS) has been one of the major strategies to combat the epidemic of tuberculosis (TB) globally. This study aimed to evaluate TB treatment outcomes between September 2004 and July 2014 under the DOTS program at one of the largest public hospitals in Ethiopia. A retrospective data of TB patients registered at Asella Teaching Hospital between September 2004 and July 2014 were obtained from hospital registry. Treatment outcomes and types of TB cases were categorized according to the national TB control program guideline. Binomial and multinomial logistic regression models were used to analyze the association between treatment outcomes and potential predictor variables. A total of 1,755 TB patients’ records were included in the study. Of these, 945 (53.8%) were male, 480 (27.4%) smear-positive TB, 287 (16.4%) HIV positive, and 1,549 (88.3%) new cases. Among 480 smear-positive pulmonary TB cases, 377 (78.5%) patients were cured, 21 (4.40) completed the treatment, 35 (7.3%) transferred out, 19 (4.0%) died, 24 (5.0%) defaulted, and 4 (0.8%) failure. Overall, 398 (82.9%) smear-positive pulmonary TB patients were successfully treated. For smear-negative TB (n = 641) and extrapulmonary TB cases (n = 634), 1,036 (81.3%) completed the treatment and demonstrated favorable response. Taking all TB types into account, 1,434 (81.7%) were considered as successfully treated. In the multivariate binary logistic model, patients in older age group (AOR = 0.386, 95% CI: 0.250–0.596) and retreatment cases (AOR = 0.422, 95% CI: 0.226–0.790) were less likely to be successfully treated compared to younger and new cases, respectively. In multinomial logistic regression, age increment by 1 year increased the risk of death and default of TB patients by 0.05 (adjusted β = 0.05; 95% CI: 0.03, 0.06) and 0.02 (adjusted β = 0.02; 95% CI: 0.01, 0.04). The odds of TB patients who died during treatment were higher among HIV-infected TB patients (adjusted β = 2.65; 95% CI: 1.28, 5.50). The treatment success rate of TB patients was low as compared to the national target. TB control needs to be strengthened for the enhancement of treatment outcome.
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