Mortality and associated risk factors in a cohort of tuberculosis patients treated under DOTS programme in Addis Ababa, Ethiopia.
Mortality and associated risk factors in a cohort of tuberculosis patients treated under DOTS programme in Addis Ababa, Ethiopia.
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DOI：
10.1186/1471-2334-11-127
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发表时间：
2011-05-16
影响因子：
3.7
通讯作者：
Medhin G
中科院分区：
文献类型：
--
作者：
Getahun B;Ameni G;Biadgilign S;Medhin G
结核病（TB）是全世界传染病中导致死亡的主要原因。 95% 的结核病病例和 98% 的结核病死亡发生在发展中国家。在全球范围内，随着有效抗结核化疗的引入，死亡率有所下降。然而，一些活动性结核病患者在接受疾病治疗时仍然死亡。在埃塞俄比亚，人们对结核病患者的生存率和死亡危险因素知之甚少。该研究的目的是确定埃塞俄比亚亚的斯亚贝巴接受 DOTS 计划治疗的结核病患者的死亡程度并确定与死亡时间相关的危险因素。这是一项回顾性队列研究。数据是通过评估 2004 年 6 月至 2009 年 7 月 G.C 登记的结核病患者的医疗记录获得的，并在三个随机选择的卫生中心按照 DOTS 策略进行治疗。使用逐步多变量 Cox 回归模型和 Kaplan-Meier 曲线对感兴趣的结果进行建模。死亡率被用作结果衡量标准。观察人年（PYO）是从开始抗结核治疗之日到结果日期计算的，并计算为死亡人数/100 PYO。统计分析 SPSS 16 版用于数据分析，当 P 值小于 5% 时，报告结果显着。总共 6,450 名登记的结核病患者中有 236 名（3.7%）死亡。超过 75% 的死亡发生在治疗开始后八个月内。从治疗开始之日起，平均生存期和中位生存期分别为 7.2 个月和 7.9 个月。使用 Kaplan Meier 曲线法和对数秩检验比较生存曲线表明，患者类别之间以及不同治疗中心的生存状况存在显着差异（P < 0.05）。肺结核阳性、肺阴性和肺外结核患者的死亡率分别为2.7%、3.6%和4.3%。开始抗结核治疗时的体重（<35 kg）、患者类别、入组年份和治疗中心是死亡时间的独立预测因素。大多数患者在治疗结束时死亡。这强调需要设计一种机制来标准化现有的 DOTS 计划和体重不足患者的营养支持，以获得更好的临床和治疗结果。
Tuberculosis (TB) is the leading cause of mortality among infectious diseases worldwide. Ninty five percent of TB cases and 98% of deaths due to TB occur in developing countries. Globally, the mortality rate has declined with the introduction of effective anti TB chemotherapy. Nevertheless, some patients with active TB still die while on treatment for their disease. In Ethiopia, little is known on survival and risk factors for mortality among a cohort of TB patients. The objective of the study is to determine the magnitude and identify risk factors associated with time to death among TB patients treated under DOTS programme in Addis Ababa, Ethiopia. This is a retrospective cohort study. Data was obtained by assessing medical records of TB patients registered from June 2004 to July 2009 G.C and treated under the DOTS strategy in three randomly selected health centers. A step-wise multivariable Cox's regression model and Kaplan- Meier curves were used to model the outcome of interest. Mortality was used as an outcome measure. Person-years of observation (PYO) were calculated from the date of starting anti-TB treatment to date of outcome and was calculated as the number of deaths/100 PYO. Statistical analysis SPSS version 16 was used for data analysis and results were reported significant whenever P-value was less than 5%. From a total of 6,450 registered TB patients 236(3.7%) were died. More than 75% death occurred within eight month of treatment initiation. The mean and median times of survival starting from the date of treatment initiation were 7.2 and 7.9 months, respectively. Comparison of survival curves using Kaplan Meier curves method with log-rank test showed that the survival status was significantly different between patient categories as well as across treatment centers (P < 0.05). The death rate of pulmonary positive, pulmonary negative and extra pulmonary TB patients were 2.7%, 3.6%, and 4.3%, respectively. Body weight at initiation of anti-TB treatment (<35 kg), patient category, year of enrollment and treatment center were independent predictors for time to death. Most of the patients were died at the end of treatment period. This underlines the need for devising a mechanism of standardizing the existing DOTS programme and nutritional support for underweight patients for better clinical and treatment outcome.
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DOI：
10.1016/s0035-9203(00)90335-3
发表时间：
2000-05-01
影响因子：
2.2
作者：
Kang'ombe, C;Harries, AD;Nunn, P
通讯作者：
Nunn, P
影响因子：
24.3
作者：
Kim, D. K.;Kim, H. J.;Lee, J-H.
通讯作者：
Lee, J-H.
影响因子：
3.7
作者：
Shen X;Deriemer K;Yuan Z;Shen M;Xia Z;Gui X;Wang L;Mei J
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Mei J
影响因子：
24.3
作者：
Borgdorff, MW;Veen, J;Nagelkerke, N
通讯作者：
Nagelkerke, N
影响因子：
158.5
作者：
FRIEDEN, TR;STERLING, T;DOOLEY, SW
通讯作者：
DOOLEY, SW