埃塞俄比亚南部Gedeo地区选定卫生机构肺结核治疗结果:一项回顾性研究

B. Ayele, Getachew Nenko
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引用次数: 8

摘要

背景:结核病仍然是埃塞俄比亚的一个主要公共卫生问题,按估计病例数计算,埃塞俄比亚在22个结核病高负担国家中排名第八。从那时起,该方案对治疗结果的影响和结核病服务覆盖面的趋势一直没有得到评估。这项研究的目的是评估埃塞俄比亚南部Gedeo地区扩大直接督导下短程化疗的趋势和结核病治疗结果。方法:对2009年9月至2014年8月Gedeo地区4家卫生机构3722例结核病患者进行分析。数据录入采用EPiData 3.1,分类结果采用STATA version12进行描述性分析和多项逻辑回归建模。采用Logistic回归对分类结果变量进行建模,估计相对风险及其相应的95%置信区间。如果p值小于5%,则报告结果具有统计学意义。结果:本院共收治3722例患者,治愈1042例(28%),完成治疗1431例(38.45%),不治疗197例(5.29%),死亡161例(4.33%),治疗失败12例(0.32%),转院879例(23.62%)。其中SPPTB 1705例(45.81%),SNPTB 1287例(34.58%),EPTB 730例(19.61%)。在艾滋病毒反应性患者和艾滋病毒检测状况未知的患者中,分别记录了更多的死亡和缺席比例。结论:与更新的全球计划(世卫组织,2011-2015年)相比,在Gedeo区卫生机构治疗的所有类型结核病患者的总有效率(66.44%)不令人满意。到2015年,总有效率将达到87%作为一个门槛。SPPTB患者的违约率和失败率高于SNPTB和EPTB,但EPTB患者的死亡率较高。与医院相比,保健中心的治疗效果更好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment Outcome of Tuberculosis in Selected Health Facilities of Gedeo Zone, Southern Ethiopia: A Retrospective Study
Background: TB continues to be a major public health problem in Ethiopia, which ranks eighth by estimated number of cases among the 22 TB high-burden countries. The impact of the programme on treatment outcomes and the trend in the service coverage for tuberculosis has not been assessed ever since. The aim of the study was to assess trends in the expansion of DOTS and treatment outcomes for tuberculosis in Gedeo zone, southern Ethiopia. Methods: 3722 TB patients in Gedeo zone, four health facilities were analysed from September 2009 to August 2014. Data entry was done by EPiData 3.1 and descriptive analysis and multinomial logistic regression modelling for categorical outcome were carried out using STATA version12. Logistic regression is used to model categorical outcome variable, to estimate the relative risk and its corresponding 95% confidence interval. Results were reported as being statistically significant if p-value was less than 5%. Result: Of 3722 patients, 1042 cured (28%), 1431 treatment completed (38.45%), 197 treatment defaulters (5.29%), 161 deaths (4.33%), 12 treatment failures (0.32%) and 879 cases transferred out (23.62%) to other health facilities were recorded in the study. In total, 1,705(45.81%) of the patients were SPPTB, 1,287(34.58%) were SNPTB and the rest 730(19.61%) were EPTB cases. More proportion of death and default were recorded among HIV reactive patients and unknown for their status on HIV test, respectively. Conclusion: TSR of all types of TB patients treated in Gedeo zone health facilities were unsatisfactory (66.44%) compared to the updated Global Plan (WHO, 2011-2015) are to achieve a TSR of 87% by 2015 as a threshold. The proportion of defaulted and failure rates were higher in SPPTB than SNPTB and EPTB but death rate was high in EPTB patients. The health centres exhibited better treatment outcomes compared to hospital.
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