Treatment Outcomes and Associated Factors in Tuberculosis Patients at Jimma University Medical Center: A 5-Year Retrospective Study
Treatment Outcomes and Associated Factors in Tuberculosis Patients at Jimma University Medical Center: A 5-Year Retrospective Study
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DOI：
10.4103/ijmy.ijmy_177_18
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发表时间：
2019-01-01
影响因子：
1.2
通讯作者：
Kebede, Wakjira
中科院分区：
文献类型：
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作者：
Abebe, Gemeda;Bonsa, Zegeye;Kebede, Wakjira
背景资料：监测结核病（TB）治疗的结果并调查与不成功结果相关的因素至关重要，因为不成功的治疗会引发对抗生素的耐药性。本研究旨在调查埃塞俄比亚西南部吉玛大学医学中心（JUMC）的治疗结果和相关因素。研究方法：进行了一项为期5年的回顾性分析研究，包括2012年9月1日至2017年8月31日期间在JUMC寻求治疗的所有类型的结核病病例。根据国家结核病控制指南对治疗结果和结核病类型进行分类。双变量分析用于分析治疗结果与潜在变量之间的关联。结果：研究纳入了1249例患者记录的总体数据。男性患者比例（815例，65.3%）高于女性。病例的平均年龄（+/-标准差，范围）为26（+/- 11. 6，1-71岁）。其中涂阳肺结核292例（23.3%），涂阴肺结核489例（39.2%），非涂阳肺结核468例（37.5%）。现有的治疗结果表明，253例（20.2%）治愈，850例（68.0%）完成治疗，58例（4.8%）死亡，83例（6.6%）失访，5例（0.4%）治疗失败。76例（5.6%）患者转出，44例（3.2%）患者失访。共有146例（11.7%）患者结局不成功。不成功的治疗结局与涂片阴性PTB（比值比[OR] = 2.0，95%置信区间[CI] = 1.1，3.7）、EPTB（OR = 2.1，95% CI = 1.2，3.4）和未知人类免疫缺陷病毒（HIV）状态（OR = 7.9，95% CI = 2.5，25.0）相关。结论：总体结核病患者的治疗成功率低于结核病战略目标>= 90%的成功率。涂片阴性的PTB、EPTB病例和HIV状态未知的病例往往结局不成功。
Background: Monitoring the outcome of tuberculosis (TB) treatment and investigating factors associated with unsuccessful outcome are essential, as unsuccessful treatment fuels resistance to antibiotics. This study aimed to investigate the treatment outcome and associated factors with an unsuccessful outcome at Jimma University Medical Center (JUMC), Southwest Ethiopia. Methods: A 5-year retrospective analytical study, including all types of TB cases who sought care at JUMC between September 1, 2012, and August 31, 2017, was conducted. Treatment outcomes and TB types were categorized according to the National TB Control guideline. Bivariate analysis was used to analyze the association between treatment outcome and potential variables. Results: Overall data from 1249 patients' records were included in the study. The proportion of male patients was higher (815, 65.3%) than that of females. The mean age (+/- standard deviation, range) of the cases was 26 (+/- 11. 6, 1-71) years. Of the total, 292 (23.3%) were smear-positive pulmonary TB (PTB), 489 (39.2%) smear-negative PTB, and 468 (37.5%) extra-PTB (EPTB) cases. Available treatment outcomes indicate that 253 (20.2%) were cured, 850 (68.0%) completed therapy, 58 (4.8%) died, 83 (6.6%) defaulted, and 5 (0.4%) failed the therapy. About 76 (5.6%) cases were transferred out and 44 (3.2%) cases were lost to follow-up. In total, 146 (11.7%) patients had an unsuccessful outcome. Unsuccessful treatment outcome was associated with smear-negative PTB (odds ratio [OR] = 2.0, 95% confidence intervals [CI] = 1.1, 3.7), EPTB (OR = 2.1, 95% CI = 1.2, 3.4), and unknown human immunodeficiency virus (HIV) status (OR = 7.9, 95% CI = 2.5, 25.0). Conclusion: The treatment success rate of overall TB patients is lower than end TB Strategy target of >= 90% success rate. Smear-negative PTB, EPTB cases, and those with unknown HIV status tend to have unsuccessful outcome.