DOTS improves treatment outcomes and service coverage for tuberculosis in South Ethiopia: a retrospective trend analysis
DOTS improves treatment outcomes and service coverage for tuberculosis in South Ethiopia: a retrospective trend analysis
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DOI：
10.1186/1471-2458-5-62
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发表时间：
2005-06-06
影响因子：
4.5
通讯作者：
Lindtjorn, B
中科院分区：
文献类型：
--
作者：
Shargie, EB;Lindtjorn, B
背景：1996年在埃塞俄比亚南部地区的结核病控制规划中引入了DOTS作为一种策略。从那时起，该方案对治疗结果的影响和结核病服务覆盖率的趋势一直没有得到评估。这项研究的目的是评估短期直接督导下的扩展趋势和结核病的治疗结果在Hadiya区在南部Ethiopia.Methods：19,971结核病患者登记在41个治疗中心在Hadiya区1994年和2001年之间的治疗被列入这项研究。这些数据是从单位结核病登记处收集的。对于每名患者，我们记录了有关人口统计学特征、治疗中心、治疗年份、疾病类别、给予的治疗、随访和治疗结果的信息。结果：2001年DOTS的人口覆盖率达到75%，接受短程化疗的患者比例从1994年的7%上升到2001年的97%。2000年，痰检阳性肺结核的治疗成功率从38%上升到73%，不治疗率从38%下降到18%，治疗失败率从5%下降到1%。作为女性患者，年龄15 - 24岁，涂阳肺结核，短程化疗治疗，并在周边中心治疗与较高的治疗成功率和较低的defaulterrates.Conclusion：引进和扩大DOTS在Hadiya导致治疗成功率显着增加，并降低违约率和失败率。与包括地区医院在内的大型机构相比，小型机构的治疗效果更好。我们发现许多患者在单位登记簿中缺少信息，这个问题需要解决。建议进行进一步研究，以了解该方案对结核病流行率和发病率的影响。
Background: DOTS as a strategy was introduced to the tuberculosis control programme in Southern region of Ethiopia in 1996. The impact of the programme on treatment outcomes and the trend in the service coverage for tuberculosis has not been assessed ever since. The aim of the study was to assess trends in the expansion of DOTS and treatment outcomes for tuberculosis in Hadiya zone in Southern Ethiopia.Methods: 19,971 tuberculosis patients registered for treatment in 41 treatment centres in Hadiya zone between 1994 and 2001 were included in the study. The data were collected from the unit tuberculosis registers. For each patient, we recorded information on demographic characteristics, treatment centre, year of treatment, disease category, treatment given, follow-up and treatment outcomes. We also checked the year when DOTS was introduced to the treatment centre.Results: Population coverage by DOTS reached 75% in 2001, and the proportion of patients treated with short course chemotherapy increased from 7% in 1994 to 97% in 2001. Treatment success for smear-positive tuberculosis rose from 38% to 73% in 2000, default rate declined from 38% to 18%, and treatment failure declined from 5% to 1%. Being female patient, age 15 - 24 years, smear positive pulmonary tuberculosis, treatment with short course chemotherapy, and treatment at peripheral centres were associated with higher treatment success and lower defaulter rates.Conclusion: The introduction and expansion of DOTS in Hadiya has led to a significant increase in treatment success and decrease in default and failure rates. The smaller institutions exhibited better treatment outcomes compared to the larger ones including the zonal hospital. We identified many patients with missing information in the unit registers and this issue needs to be addressed. Further studies are recommended to see the impact of the programme on the prevalence and incidence of tuberculosis.