在几内亚比绍内战期间结核死亡率
P Gustafson1, V F Gomes, C S Vieira
1Department of Infectious Diseases, Malmö University Hospital, S-205 02 Malmö, Sweden. Per.Gustafson@inf.mas.lu.se
JAMA
|August 14, 2001
概括
在冲突期间暂停结核病治疗显著增加了死亡率. 确保定期获得结核病药物,特别是HIV阳性个体,对于在紧急情况下的生存至关重要.
科学领域:
- 全球健康 全球健康
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 结核病 (TB) 是一个日益严重的全球健康挑战,尽管有治疗方法.
- 有限的研究存在于结核病治疗在武装冲突期间的访问.
研究的目的:
- 调查因西非几内亚比绍的武装冲突而导致的不规则结核病治疗的影响.
主要方法:
- 一项回顾性队列研究比较了在内战期间接受不规则治疗的101名结核病患者 (战争队列) 与12个月前接受定期治疗的108名结核病患者 (和平队列).
- 根据治疗规律性,治疗阶段 (密集 vs 延续) 和先前治疗完成情况,分析了死亡率.
主要成果:
- 冲突期间不规则的结核病治疗与3.12倍的死亡率增加有关 (调整后的MR,3.12;95% CI,1.20-8.12).
- 在密集治疗阶段,死亡风险更高 (调整后的MR,3.30;95% CI,1.04-10.50).
- 艾滋病毒阳性患者在不规则的治疗中经历了显著更高的死亡率增加 (调整后MR,8.19;95%CI,1.62-41.25)
结论:
- 在几内亚比绍战争期间,治疗中断严重影响了结核病患者的死亡率.
- 持续的结核病治疗改善了生存率,特别是在感染艾滋病毒的人群中.
- 在紧急情况下,保持结核病药物的可用性至关重要.
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