Spatial analysis of tuberculosis treatment outcomes in Shanghai: implications for tuberculosis control.
Spatial analysis of tuberculosis treatment outcomes in Shanghai: implications for tuberculosis control.
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上海结核病治疗结果的空间分析：对结核病控制的影响
DOI：
10.4178/epih.e2022045
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发表时间：
2022
影响因子：
3.8
通讯作者：
Zhang Z
中科院分区：
文献类型：
--
作者：
Zhang J;Shen X;Yang C;Chen Y;Guo J;Wang D;Zhang J;Lynn H;Hu Y;Pan Q;Zhang Z
结核病治疗结果是评估结核病控制规划的一项关键指标。我们的目的是确定与结核病治疗结果相关的空间因素，并从地理角度为结核病控制提供额外的见解。我们收集了来自中国上海结核病电子监测系统的数据，其中包括2009年1月1日至2016年12月31日登记的肺结核患者。在调整了人口统计学、临床和治疗因素后，我们在logistic回归模型中检验了医院的物理可达性、自回归项和随机医院效应与治疗结果的关系。在53,475例肺结核患者中，49,002例（91.6%）获得了成功的治疗结果。成功率从2009年的89.3%上升到2016年的94.4%。在8年的研究期间，不同医院的治疗成功率在78.6% ~ 97.8%之间，存在12个治疗效果不佳的空间聚类。最佳拟合模型考虑了空间因素。随机医院效应和自回归项对结核病治疗结果均有显著影响，在14个因素中分别排名第6位和第10位。家庭周围的公交车站数量是模型中最不重要的变量。空间自相关和医院效应与上海市结核病治疗结果相关。在上海等高度一体化的城市，物理可达性与治疗效果无关。政府需要更多地关注患者的流动性和医院之间治疗成功率的差异。
Tuberculosis (TB) treatment outcomes are a key indicator in the assessment of TB control programs. We aimed to identify spatial factors associated with TB treatment outcomes, and to provide additional insights into TB control from a geographical perspective. We collected data from the electronic TB surveillance system in Shanghai, China and included pulmonary TB patients registered from January 1, 2009 to December 31, 2016. We examined the associations of physical accessibility to hospitals, an autoregression term, and random hospital effects with treatment outcomes in logistic regression models after adjusting for demographic, clinical, and treatment factors. Of the 53,475 pulmonary TB patients, 49,002 (91.6%) had successful treatment outcomes. The success rate increased from 89.3% in 2009 to 94.4% in 2016. The successful treatment outcome rate varied among hospitals from 78.6% to 97.8%, and there were 12 spatial clusters of poor treatment outcomes during the 8-year study period. The best-fit model incorporated spatial factors. Both the random hospital effects and autoregression terms had significant impacts on TB treatment outcomes, ranking 6th and 10th, respectively, in terms of statistical importance among 14 factors. The number of bus stations around the home was the least important variable in the model. Spatial autocorrelation and hospital effects were associated with TB treatment outcomes in Shanghai. In highly-integrated cities like Shanghai, physical accessibility was not related to treatment outcomes. Governments need to pay more attention to the mobility of patients and different success rates of treatment among hospitals.
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影响因子：
2.9
作者：
Chen B;Liu M;Gu H;Wang X;Qiu W;Shen J;Jiang J
通讯作者：
Jiang J
影响因子：
24.3
作者：
Leung, Chi C.;Yew, Wing W.;Tam, Cheuk M.
通讯作者：
Tam, Cheuk M.
欧盟国家的结核病治疗结果监测：系统评价。
DOI：
10.1183/09031936.00030612
发表时间：
2013-03
期刊：
The European respiratory journal
影响因子：
--
作者：
van Hest R;Ködmön C;Verver S;Erkens CG;Straetemans M;Manissero D;de Vries G
通讯作者：
de Vries G
影响因子：
15.8
作者：
Shargie, Estifanos Biru;Lindtjorn, Bernt
通讯作者：
Lindtjorn, Bernt
影响因子：
4.5
作者：
Shargie, EB;Lindtjorn, B
通讯作者：
Lindtjorn, B