Evaluation of tuberculosis treatment results in Italy, report 1999.
Evaluation of tuberculosis treatment results in Italy, report 1999.
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发表时间：
2002-10
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通讯作者：
R. Centis;G. Migliori
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作者：
R. Centis;G. Migliori
在意大利，没有关于结核病治疗结果的国家数据。1995年，A.I.P.O.（意大利医院肺病专家协会）结核病研究小组与卫生部技术部门instituto Superiore di sanit<e:1>合作，根据世界卫生组织和国际防治结核病和肺病联盟的建议，开展了一项前瞻性监测活动。数据是从全国结核病单位的代表性网络收集的，该网络管理着意大利每年报告的所有结核病病例的很大一部分。本研究的目的是分析1999年的病例发现和治疗结果。报告结核病例906例（男性61.2%，外来人口36.2%），新发病例714例（78.8%）。其中肺性639例（70.5%），肺外221例（24.4%），肺外合并46例（5.1%）。结核病的主要危险因素是意大利本地人近期接触史、糖尿病和酗酒史、人类免疫缺陷病毒血清阳性状态和移民近期接触史。大多数移民来自非洲和亚洲，在诊断出结核病之前在意大利居住了超过24个月。35%（320/906）的肺部患者直接痰涂片检查酒精抗酸杆菌阳性；对任何药物均有耐药的占22.5%（对利福平单药联合耐药占1.6%，多药联合耐药占4.8%）。97%的病例治疗时间< 12个月。总成功率（治愈加上治疗完成，不包括从分母转移）为86%。意大利本地人的死亡率明显较高（与年龄有关；p < 0.001），而移民的违约率较高（p < 0.001）。
In Italy no national data on tuberculosis (TB) treatment results was available. In 1995 the A.I.P.O. (Italian Association of Hospital Pneumologists) TB Study Group, in collaboration with the Istituto Superiore di Sanità (technical branch of the Ministry of Health) started a prospective monitoring activity based on the World Health Organisation and the International Union Against Tuberculosis and Lung Disease recommendations. Data was collected from a representative network of TB units nation-wide, managing a significant proportion of all TB cases notified in Italy each year. Aim of this study was to analyse the case-finding and treatment results for 1999. 906 TB cases were reported (61.2% males; 36.2% immigrants), 714 (78.8%) being new cases. Of these cases 639 (70.5%) were pulmonary, 221 (24.4%) extrapulmonary cases and 46 (5.1%) both pulmonary and extrapulmonary. The main risk-factors for TB were history of recent contact, diabetes and alcohol abuse among native Italians, the human immunodeficiency virus-seropositive status and history of recent contact among immigrants. The majority of immigrants came from Africa and Asia, and had stayed in Italy for more than 24 months before diagnosis of TB. Thirty-five per cent (320/906) of pulmonary patients had a positive direct sputum smear examination for alcohol acid-fast bacilli; 22.5% were resistant to any drug (from combined monoresistance to rifampicin: 1.6%; combined multi-drug resistance: 4.8%). In 97% of cases the duration of treatment was < 12 months. The overall success rate (cured plus treatment completed excluding transferred out from the denominator) was 86%. A significantly higher percentage of deaths were recorded amongst native Italians (being age-related; p < 0.001) while immigrants had a higher default rate (p < 0.001).