Determinants of sputum conversion at two months of treatment under National Tuberculosis Programme, South India.
Determinants of sputum conversion at two months of treatment under National Tuberculosis Programme, South India.
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DOI：
10.5455/ijmsph.2016.20062016529
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发表时间：
2016-01-01
期刊：
影响因子：
--
通讯作者：
Tabassum, A.
中科院分区：
文献类型：
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作者：
Vijayashree Yellappa, Vijayashree Yellappa;Vani Kandpal, Vani Kandpal;Tabassum, A.
背景资料：在印度，修订后的国家结核病控制规划根据短期直接观察治疗战略提供结核病的免费诊断和治疗。在RNTCP下，治疗2个月结束时的痰菌转化率（SCR）是一个重要的操作指标，理想情况下预期为90%。目的：本研究的目的是调查与印度Tumkur区Sira TB单位治疗2个月结束时低SCR相关的因素。材料和方法：这是一项回顾性队列研究，所有新的痰涂片阳性患者登记在RNTCP在2011年。数据来自地区结核病中心的结核病登记册。使用卡方和Student t检验分析治疗2个月结束时痰菌阳性和痰菌阴性患者之间的研究变量。应用多变量logistic回归分析确定痰液未转化的变量所造成的风险。结果：268例患者痰菌阴转率为66.7%。年龄≥45岁的患者痰菌阳性的风险是2倍（OR=2.14）（P=0.007）。观察到治疗2个月后痰菌阳性的几率显著较高（OR=7.12; 95% CI = 1.00）。1.52-33.22; P=0.01）。结论：对于高菌负荷的老年患者，应给予良好的建议和咨询，以指导其坚持治疗。应提供进一步的建议，通过实行咳嗽卫生来预防疾病的传播，因为他们比其余的结核病阳性等级较低的患者更具传染性。
Background: In India, Revised National Tuberculosis (TB) control programme (RNTCP) offers free diagnosis and treat-ment for TB, based on the Directly Observed Treatment Short (DOTS) course strategy. Under RNTCP, sputum conversion rate (SCR), at the end of 2 months of treatment is an important operational indicator, which is ideally expected to be 90%. Objective: The objective of the present work was to investigate the factors associated with low SCR at the end of 2 months of treatment in Sira TB unit, Tumkur District, India. Material and Methods: It is a retrospective cohort study of all new sputum smear-positive patients registered in RNTCP in 2011. Data were retrieved from the TB register maintained at the District TB center. Chi-square and Student's t-test were used for analysis of the study variables between patients who were sputum positive and sputum negative at the end of 2 months of treatment. Multivariate logistic regression was applied to determine the risk contributed by the variables towards non-conversion of sputum. Results: Of the 268 included patients, 66.7% patients were sputum negative. Patients aged ≥45 years were twice the risk of being sputum positive (OR=2.14) (P=0.007). The odds of being sputum positive after 2 months of treatment was observed to be significantly high (OR=7.12; 95% C.I.=1.52-33.22; P=0.01) for sputum grade 3+ at the time of diagnosis, respectively. Conclusion: Elderly patients with a high bacilli load should be advised and counselled well regarding adherence to treat-ment. Further advice should be given on preventing spread of the disease by practising cough hygiene, as they are more infectious than remaining patients with less sputum-positive grade.