Tuberculosis treatment adherence and fatality in Spain.
Tuberculosis treatment adherence and fatality in Spain.
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DOI：
10.1186/1465-9921-10-121
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发表时间：
2009-12-01
影响因子：
5.8
通讯作者：
Working Group on Completion of Tuberculosis Treatment in Spain (Study ECUTTE)
中科院分区：
文献类型：
--
作者：
Caylà JA;Rodrigo T;Ruiz-Manzano J;Caminero JA;Vidal R;García JM;Blanquer R;Casals M;Working Group on Completion of Tuberculosis Treatment in Spain (Study ECUTTE)
坚持长期结核病治疗是结核病控制计划中的一个关键因素。总是有一些患者放弃治疗或死亡。这项研究的目的是确定与在抗结核治疗中违约或死亡相关的因素。对西班牙肺科和胸科外科学会(SEPAR)61名成员在2006-2007年期间诊断的大量结核病病例进行的前瞻性研究。根据Logistic回归，计算优势比(OR)和95%的可信区间(CI)，预测完成结果(治愈+完成治疗与违约者+失访)和病死率(死亡与其余患者)。在纳入的1490名患者中，29.7%是外国出生的。治疗结果：治愈792例(53.2%)，完成治疗540例(36.2%)，失败2例(0.1%)，转出33例(2.2%)，违约27例(1.8%)，死亡27例(1.8%)，失访65例(4.4%)，其他4例(0.3%)。完成率达93.5%，服药依从性差的相关因素有：移民(OR=2.03；CI：1.06~3.88)、独居(OR=2.35；CI：1.05~5.26)、收容所居民(OR=4.79；CI：1.74~13.14)、既往治疗(OR=2.93；CI：1.44~5.98)、注射吸毒者(IDU)(OR=9.51；CI：2.70~33.47)和治疗理解困难(OR=2.93；CI：1.44~5.98)。病死率为1.8%，与以下变量有关：50岁及以上(OR=10.88；CI：1.12~105.01)、退休(OR=12.26；CI：1.74~86.04)、HIV感染者(OR=9.93；CI：1.48~66.34)、理解困难(OR=4.07；CI：1.24~13.29)、吸毒(OR=23.59；CI：2.46~225.99)和直接观察治疗(OR=3.54；CI：1.07-11.77)。移民、独居者、受限机构的居民、以前接受过治疗的患者、治疗理解困难的患者以及注射吸毒者依从性差，应作为DOT的目标。为了降低病死率，需要对退休、艾滋病毒感染、静脉注射吸毒者和治疗理解困难的患者进行更严格的监测。
The adherence to long tuberculosis (TB) treatment is a key factor in TB control programs. Always some patients abandon the treatment or die. The objective of this study is to identify factors associated with defaulting from or dying during antituberculosis treatment. Prospective study of a large cohort of TB cases diagnosed during 2006-2007 by 61 members of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). Predictive factors of completion outcome (cured plus completed treatment vs. defaulters plus lost to follow-up) and fatality (died vs. the rest of patients) were based on logistic regression, calculating odds ratios (OR) and 95% confidence intervals (CI). Of the 1490 patients included, 29.7% were foreign-born. The treatment outcomes were: cured 792 (53.2%), completed treatment 540 (36.2%), failure 2 (0.1%), transfer-out 33 (2.2%), default 27 (1.8%), death 27 (1.8%), lost to follow-up 65 (4.4%), other 4 (0.3%). Completion outcome reached 93.5% and poor adherence was associated with: being an immigrant (OR = 2.03; CI:1.06-3.88), living alone (OR = 2.35; CI:1.05-5.26), residents of confined institutions (OR = 4.79; CI:1.74-13.14), previous treatment (OR = 2.93; CI:1.44-5.98), being an injecting drug user (IDU) (OR = 9.51; CI:2.70-33.47) and treatment comprehension difficulties (OR = 2.93; CI:1.44-5.98). Case fatality was 1.8% and it was associated with the following variables: age 50 or over (OR = 10.88; CI:1.12-105.01), retired (OR = 12.26;CI:1.74-86.04), HIV-infected (OR = 9.93; CI:1.48-66.34), comprehension difficulties (OR = 4.07; CI:1.24-13.29), IDU (OR = 23.59; CI:2.46-225.99) and Directly Observed Therapy (DOT) (OR = 3.54; CI:1.07-11.77). Immigrants, those living alone, residents of confined institutions, patients treated previously, those with treatment comprehension difficulties, and IDU patients have poor adherence and should be targeted for DOT. To reduce fatality rates, stricter monitoring is required for patients who are retired, HIV-infected, IDU, and those with treatment comprehension difficulties.
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影响因子：
120.7
作者：
Dye, C;Scheele, S;Raviglione, RC
通讯作者：
Raviglione, RC
影响因子：
24.3
作者：
Kliiman, K.;Altraja, A.
通讯作者：
Altraja, A.
影响因子：
24.3
作者：
Marco, A;Cayla, JA;Ribot, N
通讯作者：
Ribot, N
DOI：
10.1164/rccm.200401-095oc
发表时间：
2004-09-01
影响因子：
24.7
作者：
Jasmer, RM;Seaman, CB;Daley, CL
通讯作者：
Daley, CL
影响因子：
24.3
作者：
Lefebvre, N.;Falzon, D.
通讯作者：
Falzon, D.