The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility.
The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility.
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DOI：
10.1155/2023/6648137
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发表时间：
2023
影响因子：
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通讯作者：
Seraphin, Marie Nancy
中科院分区：
文献类型：
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作者：
Afriyie-Mensah, Jane S;Aryee, Robert;Zigah, Francisca;Amaning-Kwarteng, Ernest;Seraphin, Marie Nancy
我们的目的是调查与三级结核病转诊中心管理的患者结核病死亡率相关的人口统计学和临床因素。 我们对 2017 年 1 月至 2020 年 12 月期间在加纳阿克拉 Korle-Bu 教学医院 (KBTH) 胸科就诊的 1,933 名结核病患者的医疗记录进行了回顾性审查。结核病死亡率定义为在治疗过程中因任何原因死亡的任何结核病患者。使用多变量逻辑回归来估计与结核病死亡率相关的因素的调整优势比（95％置信区间）。 研究期间，共有 1,933 名结核病患者在胸科诊所登记。男性占 1,227 人（63.5%），大多数参与者年龄在 24 至 64 岁之间。肺结核（PTB）和肺外结核（EPTB）病例分别占结核病例总数的51%和48.4%。很大一部分（69%）接受结核病治疗的患者没有对该疾病进行细菌学证实。大约 34% 的接受检测的结核病患者 HIV 呈阳性。患者死亡率为33.6%。在多变量回归模型中，与 HIV 阴性患者相比，HIV 阳性患者的死亡风险增加了 3 倍以上。与确诊的结核病患者相比，经验诊断的结核病患者的死亡风险增加。 在胸科门诊就诊的患者中，临床诊断出结核病的比例很高。 HIV/结核病合并感染患者以及经验性结核病诊断患者的死亡率较高。
We aimed to investigate the demographic and clinical factors associated with TB mortality in patients managed at a tertiary TB referral center. We conducted a retrospective review of the medical records of 1,933 TB patients seen between January 2017 and December 2020 at the Korle-Bu Teaching Hospital (KBTH) Chest Department in Accra, Ghana. TB mortality was defined as any TB patient who died for any reason during the course of treatment. Multivariable logistic regression was used to estimate adjusted odds ratios with 95% confidence intervals for factors associated with TB mortality. A total of 1,933 patients with TB were registered at the chest clinic over the study period. Males accounted for 1,227 (63.5%), and majority of participants were between 24 and 64 years old. Pulmonary TB (PTB) and extrapulmonary TB (EPTB) cases accounted for 51% and 48.4% of the total TB cases, respectively. A significant proportion (69%) of the patients managed for TB had no bacteriological confirmation of the disease. About 34% of tested TB patients were HIV positive. Mortality among patients was 33.6%. In a multivariable regression model, patients with HIV positive status had over 3-fold increased risk of mortality, compared to those with HIV negative status. TB patients diagnosed empirically had an increased risk of death compared to those with a confirmed diagnosis. The proportion of clinically diagnosed TB was high among the patients seen at the chest clinic. Mortality was high among the patients with HIV/TB coinfection as well as in patients with empirical TB diagnosis.