台湾非爱滋病患者结核病复发率及相关危险因素：一项回顾性队列研究

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-07-23 DOI:10.1016/j.jiph.2025.102912

Che-min Hsu , Chia-Ju Wu , Chih-Jung Chang , Sheng-Wei Pan , Yen-Han Tseng , Jhong-Ru Huang , Wei-Juin Su , Jia-Yih Feng , Yuh-Min Chen

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引用次数: 0

摘要

背景/目的尽管短期抗结核（TB）治疗有效，但结核病复发仍然是一个重大的公共卫生问题。本研究旨在探讨台湾地区结核病复发率及其相关危险因素。方法选取2012 - 2019年在台北退伍军人总医院完成抗结核治疗的活动性结核病患者并纳入分析。所有入组病例随访长达6年，使用台湾CDC登记数据库确定结核复发。研究了每年结核病复发率的演变趋势。与结核病复发相关的独立人口学、临床和微生物因素也被调查。结果共纳入1875例活动性结核病患者。总体结核病复发率确定为2.0 %（每10万人年434人），中位随访时间为72个月。2017年后复发率明显下降。复发率高峰出现在治疗结束后的第二年。独立与结核病复发相关的因素包括身体质量指数(BMI) & lt; 20 公斤/ m²(调整风险比(aHR): 4.38, 95 % CI: 1.70 - -11.30, p = 0.002),以前的结核病史(aHR 4.28, 95 %置信区间:1.77—-10.35,p = 0.001),和两个月痰结核文化non-conversion (aHR: 3.37, 95 % CI: 1.36 - -8.38, p = 0.009)。这些观察结果通过亚组分析得到进一步证实，包括肺结核和培养证实的肺结核。结论台湾地区结核病复发率低且呈下降趋势。与结核病复发相关的独立因素包括低BMI、既往结核病和2个月痰结核培养未转化。

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Recurrence of tuberculosis and associated risk factors among Non-HIV patients in Taiwan: A retrospective cohort study

Background/Purpose

Despite effective short-course anti-tuberculosis (TB) treatments, TB recurrence remains a significant public health issue. This study aims to investigate the rate of TB recurrence and its associated risk factors in Taiwan.

Methods

Patients with active TB who completed anti-TB treatment from 2012 to 2019 at Taipei Veterans General Hospital were identified and included in the analysis. All enrolled cases were followed for up to 6 years to identify TB recurrence using the CDC registration database in Taiwan. The evolving trends in annual TB recurrence rates were examined. Independent demographic, clinical, and microbiological factors associated with TB recurrence were also investigated.

Results

A total of 1875 patients with active TB were enrolled in the analysis. The overall TB recurrence rate was determined to be 2.0 % (434 per 100,000 person-years), with a median follow-up duration of 72 months. A notable decline in the recurrence rate was observed post-2017. The peak recurrence rate was observed during the second year following treatment completion. Independent factors associated with TB recurrence included a body mass index (BMI) <20 kg/m² (adjusted hazard ratio [aHR]: 4.38, 95 % CI:1.70–11.30, p = 0.002), a history of previous TB (aHR 4.28, 95 % CI: 1.77–10.35, p = 0.001), and 2-month sputum TB culture non-conversion (aHR:3.37, 95 % CI: 1.36–8.38, p = 0.009). These observations were further corroborated through subgroup analyses, encompassing pulmonary TB and culture-confirmed pulmonary TB.

Conclusions

The TB recurrence rate in Taiwan is low and shows a declining trend. Independent factors associated with TB recurrence included low BMI, previous TB, and 2-month sputum TB culture non-conversion.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.