在刚果共和国布拉柴维尔抗结核中心接受治疗的结核病患者的结核病治疗结果及其相关因素

IF 1.5 Q4 INFECTIOUS DISEASES
Breli Bonheur Ngouama , Freisnel Hermeland Mouzinga , Mita Naomie Merveille Dello , Jean Claude Djontu , Darrel Ornelle Elion Assiana , Franck Hardain Okemba Okombi , Salomon Bonsi Tchuandom , Michel Illoye Ayet , Lemercier Khunell Siele , Jeannhey Christevy Vouvoungui , Martin Peter Grobusch , Alain Maxime Mouanga , Alain Brice Vouidibio Mbozo , Francine Ntoumi
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引用次数: 0

摘要

目的结核病治疗效果是评价结核病防治工作成效的关键指标之一。本研究旨在评估在刚果共和国布拉柴维尔抗结核中心接受治疗的患者的结核病治疗结果及其相关因素。方法于2022年7月至2023年8月在布拉柴维尔抗结核中心进行了一项前瞻性队列研究,涉及305例用GenXpert MTB/RIF检测诊断的肺结核患者。这些患者在接受治疗时使用抗酸芽孢杆菌显微镜密切监测其是否药物敏感(DS)或耐药。DS患者的痰样本在2个月、5个月和6个月时进行分析,而耐多药(MDR)患者每月进行一次痰样本分析,持续9个月。结果总治愈率为80.3%,治愈率为70.8%,完成治疗率为9.5%。相反,19.7%经历了不成功的结果,包括13.4%的随访损失,3.6%的死亡和1.6%的治疗失败。同时感染HIV的患者的治疗成功率为46.7%(15人中有7人),而耐多药患者的治疗成功率为42%(19人中有8人)。hiv阴性状态(调整后优势比= 5.11;95%可信区间:1.73-13.44)和DS-TB(校正优势比= 8.29;95%可信区间:3.17-21.04)与治疗结果的成功率增加相关。结论总体结核病治疗成功率低于世界卫生组织终止结核病战略的阈值,患者失访率高,TB/HIV患者和耐多药患者的治疗成功率低。研究结果强调需要加强监督,改善直接观察治疗的短期监测,并制定策略以尽量减少患者的随访损失。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tuberculosis treatment outcomes and their related factors in patients with tuberculosis treated at the Antituberculosis Center of Brazzaville, Republic of Congo

Objectives

Tuberculosis (TB) treatment outcome is one of the key indicators to evaluate the performance of TB control programs. This study aims to assess TB treatment outcomes and their related associated factors in patients treated at the Antituberculosis Center of Brazzaville, Republic of Congo.

Methods

A prospective cohort study was conducted at the Antituberculosis Center of Brazzaville from July 2022 to August 2023, involving 305 patients with pulmonary TB diagnosed with the GenXpert MTB/RIF assay. These patients were closely monitored using acid-fast bacillus microscopy while receiving treatment based on whether they were drug-sensitive (DS) or drug-resistant. Sputum samples from patients who were DS were analyzed at 2, 5, and 6 months, whereas patients who were multi-drug–resistant (MDR) underwent a monthly sputum analysis for 9 months.

Results

The overall successful treatment rate was 80.3%, with 70.8% of patients cured and 9.5% completing treatment. Conversely, 19.7% experienced unsuccessful outcomes, including 13.4% loss to follow-up, 3.6% deaths, and 1.6% treatment failures. The treatment success in individuals co-infected with HIV was 46.7% (seven of 15), whereas it was 42% (eight in 19) in patients who were MDR. HIV-negative status (adjusted odds ratio = 5.11; 95% confidence interval: 1.73-13.44) and DS-TB (adjusted odds ratio = 8.29; 95% confidence interval: 3.17-21.04) were associated with increased success of treatment outcome.

Conclusions

The overall TB treatment success rate was below the World Health Organization End TB Strategy threshold, with a high proportion of patients lost to follow-up and a low treatment success in patients with TB/HIV and those who were MDR. The findings highlight the need to enhance supervision, improve directly observed treatment short course monitoring, and develop strategies to minimize patients lost to follow-up.
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来源期刊
IJID regions
IJID regions Infectious Diseases
CiteScore
1.60
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