Morbidity and mortality up to 5 years post tuberculosis treatment in South Africa: A pilot study
Morbidity and mortality up to 5 years post tuberculosis treatment in South Africa: A pilot study
复制标题
DOI：
10.1016/j.ijid.2019.05.024
复制
发表时间：
2019-08-01
影响因子：
8.4
通讯作者：
Marx, Florian M.
中科院分区：
文献类型：
--
作者：
Osman, Muhammad;Welte, Alex;Marx, Florian M.
背景：在有结核病治疗史的人群中，结核病(TB)、慢性肺部疾病和死亡率的高风险已被报道，但来自高发病率环境的数据仍然有限。这项研究的目的是描述在南非高发地区过去5年成功完成结核病治疗的成年人的总体发病率和死亡率。方法：从结核病治疗登记中随机选择2013至2017年间完成肺结核治疗的成年人(年龄=18岁)。进行了家庭走访，以定位和访谈以前的结核病患者，并提供了结核病细菌学检测。结果：在抽样调查的223名FTB患者中，有200人找到了住址，并联系了89名FTB患者，其中51人同意接受采访。大约一半的人报告了持续的呼吸道症状，如呼吸急促和喘息，以及反复肺部感染。在提供痰样本的28名患者中，有一人(3.6%)患有培养阳性结核病，另有两人目前正在重新治疗结核病。共查出15例治疗后死亡病例，其标准化死亡率为3.8(95%可信区间2.3~6.3)。结论：在这一高发环境中，寻找和采访FTB患者具有挑战性。这项研究结果与呼吸系统疾病的高发病率一致，包括复发性结核病，以及FTB患者死亡率的大幅上升。(C)2019年提交人(S)。爱思唯尔有限公司代表国际传染病学会出版。
Background: A high risk of tuberculosis (TB), chronic lung disease, and mortality have been reported among people with a history of previous TB treatment, but data from high-incidence settings remain limited. The aim of this study was to characterize general morbidity and mortality among adults who had successfully completed TB treatment in the past 5 years in a high-incidence setting in South Africa.Methods: Adults (>= 18 years) who had completed treatment for pulmonary TB between 2013 and 2017 were randomly selected from TB treatment registers. Household visits were conducted to locate and interview former TB (FTB) patients, and bacteriological testing for TB was offered. Additional data sources were used to ascertain the vitality status of FTB patients who could not be located.Results: Addresses were located for 200 of the 223 FTB patients sampled and 89 FTB patients were contacted of whom 51 agreed to be interviewed. Approximately half reported persistent respiratory symptoms, such as shortness of breath and wheezing, and repeated lung infections. One (3.6%) of 28 patients who provided a sputum sample had culture-positive TB and another two were currently on re-treatment for TB. Fifteen deaths post treatment were ascertained, resulting in a standardized mortality ratio of 3.8 (95% confidence interval 2.3-6.3) after successful TB treatment relative to the general population.Conclusions: In this high-incidence setting, locating and interviewing FTB patients was challenging. The study findings are consistent with a high rate of respiratory disease, including recurrent TB, and substantially elevated mortality among FTB patients. (C) 2019 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.