Fentie Atalay Mulu, Jorgi Tadesse, Assefa Tamrat
1School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Addis Ababa Heath Bureau, Addis Ababa, Ethiopia.
Arch Public Health. 2020 Mar 10;78:12. doi: 10.1186/s13690-020-0393-6. eCollection 2020.
Despite the availability of effective drugs, tuberculosis remains a major public health problem that predominantly affects low- and middle-income countries. This study aimed to assess tuberculosis treatment outcomes among patients treated at one of the primary health care levels in Addis Ababa, Ethiopia.
An institutional-based retrospective cross-sectional study was conducted at a tuberculosis clinic in public primary healthcare facility. The study populations were all patients with tuberculosis who had been completed their treatment course in the center from July 2014 to July 2018. After getting Ethical clearance and permission from the health center, trained data collectors working in the center were recruited. The collected data were checked for completeness every day by the principal investigators. Data were edited, cleaned, and analyzed using SPSS version 25. Descriptive statistics were used to summarize the data while multinomial logistic regression was employed to explore associations among variables of interest, and < 0.05 was considered as statistically significant.
A total of 352 patients with tuberculosis were included for the study with a median age of 25 years which ranged from 1 to79 year. Most (36.4%) participants were in the age group of 15 to 24 years. The majority (38.8%) of patients had extrapulmonary tuberculosis, 11.9% of them were HIV positive and only two had family history of tuberculosis. Regarding treatment outcome, 238(67.6%) completed the treatment, 95(27%) cured and the rest were unsuccessful treatment outcomes 19(5.4%) either died, defaulted or treatment failed. The odds ratio for cured in relation to unsuccessful treatment outcome was found to be significantly higher in HIV negative patients (AOR = 6.1; 95%CI 2.1-13.9) compared with those patients tested positive for HIV. While patients with smear-positive pulmonary tuberculosis (AOR = 10.5, 95% CI 5.36-16.31) were significantly associated with the odds of having complete treatment cure as compared to patients with extrapulmonary tuberculosis. Similarly being HIV positive and extrapulmonary tuberculosis were predicting factors for unsuccessful treatment compared with their counterparts.
The finding of the present study showed that successful tuberculosis treatment outcome was found to be optimal.
尽管有有效的药物,但结核病仍然是一个主要的公共卫生问题,主要影响低收入和中等收入国家。本研究旨在评估在埃塞俄比亚亚的斯亚贝巴的一个初级卫生保健机构接受治疗的患者的结核病治疗结果。
在一个公共初级卫生保健机构的结核病诊所进行了一项基于机构的回顾性横断面研究。研究对象为2014年7月至2018年7月在该中心完成治疗疗程的所有结核病患者。在获得伦理批准和卫生中心的许可后,招募了在该中心工作的经过培训的数据收集员。主要研究者每天检查收集到的数据的完整性。使用SPSS 25版对数据进行编辑、清理和分析。描述性统计用于汇总数据,多项逻辑回归用于探索感兴趣变量之间的关联,P < 0.05被认为具有统计学意义。
共有352例结核病患者纳入研究,中位年龄为25岁,年龄范围为1至79岁。大多数(36.4%)参与者年龄在15至24岁之间。大多数(38.8%)患者患有肺外结核,其中11.9%为HIV阳性,只有2例有结核病家族史。关于治疗结果,238例(67.6%)完成治疗,95例(27%)治愈,其余治疗结果不佳,19例(5.4%)死亡、失访或治疗失败。与HIV检测呈阳性的患者相比,HIV阴性患者治愈相对于治疗结果不佳的优势比显著更高(调整后比值比 = 6.1;95%置信区间2.1 - 13.9)。与肺外结核患者相比,涂片阳性肺结核患者(调整后比值比 = 10.5,95%置信区间5.36 - 16.31)与完全治愈治疗的几率显著相关。同样,与相应的患者相比,HIV阳性和肺外结核是治疗结果不佳的预测因素。
本研究结果表明,结核病治疗的成功结果是最佳的。