Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia
Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia
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DOI：
10.2147/ijgm.s135305
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发表时间：
2017-01-01
影响因子：
2.3
通讯作者：
Anagaw, Yeniewa Kerie
中科院分区：
文献类型：
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作者：
Kefale, Adane Teshome;Anagaw, Yeniewa Kerie
背景：合并HIV感染给结核病的治疗带来挑战，并使预后恶化。本研究旨在评估埃塞俄比亚Mizan-Tepi大学教学医院（MTUTH）艾滋病毒感染患者的结核病治疗结果及其预测因素。方法：回顾2012年9月至2015年12月在MTUTH结核病门诊就诊的188例TB/HIV合并感染患者的医疗记录（2016年3月14日至4月1日）。研究的主要终点是结核病的治疗结果及其预测因素。数据分析采用Statistical Package for Social Sciences version 21。进行多变量二元logistic回归分析以确定治疗结果的预测因素。p值< 0.05认为有统计学意义。结果：本研究纳入的结核病患者治疗结果为治愈18例（9.57%），未治愈20例（10.64%），死亡24例（12.77%），完成治疗39例（20.74%），转院87例（46.28%）。57例（30.32%）患者治疗成功。初始世界卫生组织（WHO）临床III期（COR: 2.60; 95% CI: 1.17-5.76）和IV期（COR: 4.00; 95% CI: 1.29-12.40）与不良结局相关。诊断HIV时的WHO分期（III、IV期）均为不良治疗结果的独立预测因子（AOR: 3.08; 95% CI: 1.14-8.38; AOR: 5.80; 95% CI: 1.36-24.71）。然而，涂片阳性结核是良好治疗结果的独立预测因子（AOR: 2.50; 95% CI: 1.13-5.51）。结论：本研究显示结核病患者的治疗效果不理想，这表明需要改善护理。世卫组织临床分期较晚是预后较差的预测因素，而涂片阳性结核病倾向于预后较好。
Background: Co-infection with HIV challenges treatment of tuberculosis (TB) and worsens the outcome. This study aimed to assess the outcome of TB treatment and its predictors among HIV infected patients at Mizan-Tepi University Teaching Hospital (MTUTH), Ethiopia.Methods: Medical records of 188 TB/HIV co-infected patients who attended the TB clinic of MTUTH from September 2012 to December 2015 were reviewed from March 14 to April 1, 2016. The primary endpoints of the study were treatment outcome of TB and its predictors.Data were analyzed by Statistical Package for Social Sciences version 21. Multivariable binary logistic regression analysis was carried out to identify predictors of treatment outcome. Statistical significance was considered at p-value < 0.05.Result: The treatment outcomes of TB patients included in this study were 18 (9.57%) cured, 20 (10.64%) defaulted, 24 (12.77%) died, 39 (20.74%) completed the treatment, and 87 (46.28%) transferred out. A successful treatment outcome was achieved in 57 (30.32%) patients. Initial World Health Organization (WHO) clinical stage III (COR: 2.60; 95% CI: 1.17-5.76) and stage IV (COR: 4.00; 95% CI: 1.29-12.40) were associated with unfavorable outcome. Both WHO stages (III, IV) at the time of HIV diagnosis were independent predictors of poor treatment outcome (AOR: 3.08; 95% CI: 1.14-8.38; AOR: 5.80; 95% CI: 1.36-24.71 respectively). However, smear positive TB was an independent predictor of a favorable treatment outcome (AOR: 2.50; 95% CI: 1.13-5.51).Conclusion: This study revealed that treatment outcome of TB patients was unsatisfactory, which signals a need for improved care. Advanced WHO clinical stages were predictors of poor outcome, while smear positive TB favors good outcome.