Tuberculosis treatment outcome and predictors in northern Ethiopian prisons: a five-year retrospective analysis.
Tuberculosis treatment outcome and predictors in northern Ethiopian prisons: a five-year retrospective analysis.
复制标题
DOI：
10.1186/s12890-018-0600-1
复制
发表时间：
2018-02-20
影响因子：
3.1
通讯作者：
Dinant GJ
中科院分区：
文献类型：
--
作者：
Adane K;Spigt M;Dinant GJ
监狱的情况因导致结核病治疗中断和出现不利结果而臭名昭著。在埃塞俄比亚监狱，虽然存在结核病治疗方案，但治疗结果和导致不成功结果的因素没有很好的记录。在这项研究中，我们评估了埃塞俄比亚北部监狱结核病病例的治疗结果，并确定了结果不成功的危险因素。对2011年9月至2015年8月期间诊断患有结核病的所有囚犯进行了回顾性记录审查。结果变量根据世卫组织指南定义。在496例患者中，11.5%治愈，68%完成治疗，2.5%失去随访，1.6%治疗失败，1.4%死亡，15%转院。所有转出或释放的囚犯都没有适当地与卫生设施联系起来，可能无法进行后续治疗。未转出的患者5年总体治疗成功率（TSR）为94%。与新治疗病例相比，再治疗病例的不成功几率为4.68倍。治疗年份也与TSR的变化有关；那些在早期接受治疗的人更有可能没有成功的结果。在涂片阳性病例中，第二个月检查时痰液未转化与预后不佳密切相关。与终止结核病战略设定的目标水平相比，研究监狱中囚犯的平均TSR相当令人满意。然而，对那些在治疗完成前被转移或释放的囚犯缺乏适当的联系和跟踪系统，将对国家结核病控制规划产生负面影响，因为这些患者可能中断治疗并发展为耐药结核病。在所有形式和痰检阳性结核病例中，再次接受治疗方案和第二个月检查时痰液未转化分别与治疗结果不成功显著相关。
The prison situations are notorious for causing interruptions of tuberculosis (TB) treatment and occurrence of unfavorable outcomes. In Ethiopian prisons, though TB treatment programs exist, treatment outcome results and factors contributing to unsuccessful outcome are not well documented. In this study, we assessed the treatment outcome of TB cases and identified risk factors for unsuccessful outcome in northern Ethiopian prisons. A retrospective record review was conducted for all prisoners diagnosed with TB between September 2011 and August 2015. Outcome variables were defined following WHO guidelines. Out of the 496 patients, 11.5% were cured, 68% completed treatment, 2.5% were lost to follow-up, 1.6% were with a treatment failure, 1.4% died, and 15% were transferred out. All transferred out or released prisoners were not appropriately linked to health facilities and might be lost to treatment follow-up. The overall treatment success rate (TSR) of the 5 years was 94% among the patients who were not transferred out. The odds of unsuccessful outcome were 4.68 times greater among re-treatment cases compared to the newly treated cases. The year of treatment was also associated with variations in TSR; those treated during the earlier year were more likely to have unsuccessful outcome. Sputum non-conversion at the second-month check-up was strongly associated with unsuccessful outcome among the smear-positive cases. The mean TSR of the prisoners in the study prisons was quite satisfactory when gauged against the target level set by the End TB Strategy. However, the lack of appropriate linkage and tracking systems for those prisoners transferred or released before their treatment completion would have a negative implication for the national TB control program as such patients might interrupt their treatment and develop drug-resistant TB. Being in a re-treatment regimen and sputum non-conversion at the second-month check-up were significantly associated with unsuccessful treatment outcome among the all forms of and smear-positive TB cases, respectively.
登录
查看更多内容
影响因子：
24.3
作者：
Kliiman, K.;Altraja, A.
通讯作者：
Altraja, A.
影响因子：
3.7
作者：
Getahun B;Ameni G;Biadgilign S;Medhin G
通讯作者：
Medhin G
影响因子：
--
作者：
Iwnetu, Rahel;Van Den Hombergh, Jan;Aseffa, Abraham
通讯作者：
Aseffa, Abraham
影响因子：
1.2
作者：
Tesfay, Kebede;Tesfay, Shinesh;Adane, Kelemework
通讯作者：
Adane, Kelemework
影响因子：
4.5
作者：
Berhe, Gebretsadik;Enquselassie, Fikre;Aseffa, Abraham
通讯作者：
Aseffa, Abraham