肺结核与肺外结核的相关因素:个案研究

Microbiology insights Pub Date : 2019-04-04 eCollection Date: 2019-01-01 DOI:10.1177/1178636119840362
Alberto Arnedo-Pena, Maria Angeles Romeu-Garcia, Noemi Meseguer-Ferrer, Iraya Vivas-Fornas, Ana Vizcaino-Batllés, Lourdes Safont-Adsuara, Juan Bautista Bellido-Blasco, Rosario Moreno-Muñoz
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引用次数: 0

摘要

背景:在卡斯特利翁和拉普拉纳-维拉雷亚尔的卫生部门,结核病(TB)的发病率仍然很低,但消除结核病却面临挑战。本研究的目的是估算肺结核(PTB)与肺外结核(ETB)的相关因素,并调查这些病症的流行病学特征,以确定控制和预防行动的方向:西班牙巴伦西亚大区卡斯特利翁省的卡斯特利翁总医院和拉普拉纳-维拉-雷亚尔医院实验室根据通报报告、流行病学监测和微生物学结果,对 2013-2016 年期间的 PTB 和 ETB 发病率进行了比较,从而开展了一项前瞻性病例研究。在此设计中,病例为 PTB 患者,对照为 ETB 患者。在选择潜在风险和混杂因素时采用了有向无环图方法。通过逻辑回归模型估算出调整后的几率比(AORs):研究纳入了 136 名 PTB 患者和 57 名 ETB 患者,微生物学确诊率分别为 93.4% 和 52.6%,年发病率中位数分别为每 10 万居民 7.5 例和 3.1 例。一般来说,与 ETB 患者相比,PTB 患者更年轻,男性比例更高。肺结核的风险因素包括吸烟(AOR = 3.98;95% 置信区间 [CI] = 1.66-9.56)、社会问题(社会边缘化、无家可归、住在穷人收容所或在监狱服刑)(AOR = 3.39;95% CI = 1.05-10.94)以及与肺结核患者接触(AOR = 2.51;95% CI = 1.06-5.95)。不吸烟和不滥用药物会降低 PTB 风险(AOR = 0.27;95% CI = 0.12-0.64)。从这些结果中可以得出促进和预防健康的具体措施:结论:估计的肺结核相关因素是可以预防的,这也证明了病例设计在肺结核研究中是有用的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Pulmonary Versus Extrapulmonary Tuberculosis Associated Factors: A Case-Case Study.

Pulmonary Versus Extrapulmonary Tuberculosis Associated Factors: A Case-Case Study.

Pulmonary Versus Extrapulmonary Tuberculosis Associated Factors: A Case-Case Study.

Pulmonary Versus Extrapulmonary Tuberculosis Associated Factors: A Case-Case Study.

Background: Tuberculosis (TB) incidence remains low in health departments of Castellon and La Plana-Vila-real, but TB elimination is challenging. The objective of this study was to estimate associated factors of pulmonary tuberculosis (PTB) compared with extrapulmonary tuberculosis (ETB) and investigate epidemiological characteristics of these pathologies to orient control and prevention actions.

Materials and methods: A prospective case-case study was implemented by comparing PTB and ETB incidences during 2013-2016 from notification reports, epidemiological surveillance, and microbiological results of hospitals' laboratories Hospital General Castellon and La Plana-Vila-Real in the province of Castellon of Valencia region in Spain. In this design, cases were patients with PTB and controls were patients with ETB. Directed acyclic graph approach was used for selection of potential risk and confounding factors. Adjusted odds ratios (AORs) were estimated by logistic regression models.

Results: The study included 136 patients with PTB and 57 patients with ETB, with microbiological confirmation of 93.4% and 52.6%, and the annual median of incidence rates were 7.5 and 3.1 per 100 000 inhabitants, respectively. In general, patients with PTB were younger with higher male proportion than patients with ETB. Risk factors of PTB were smoking tobacco (AOR = 3.98; 95% confidence interval [CI] = 1.66-9.56), social problems (social marginalization, homeless, residence in shelters for the poor, or stay in prison) (AOR = 3.39; 95% CI = 1.05-10.94), and contact with patients with TB (AOR = 2.51; 95% CI = 1.06-5.95). No-smoking tobacco and no-drug abuse interaction decrease PTB risk (AOR = 0.27; 95% CI = 0.12-0.64). From these results, specific measures of health promotion and prevention can be addressed.

Conclusions: The estimated associated factors of PTB may be prevented, and it was demonstrated that the case-case design is useful in the study of TB.

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