结核病治疗中断的特征,预测因素和后果:一个多中心回顾性队列研究
Ai Ling Oh1,2, Mohd Makmor-Bakry1,3, Farida Islahudin1
1Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Tropical medicine & international health : TM & IH
|March 12, 2024
概括
结核病 (TB) 治疗中断影响超过16%的患者,通常发生在治疗的早期. 药物不良反应,吸烟和药物使用预测中断,导致更差的结果.
科学领域:
- 公共卫生 公共卫生
- 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) 治疗中断是一个重大挑战,与治疗结果差以及药物耐药性的发展有关.
- 了解结核病治疗中断的模式和驱动因素对于改善患者管理和公共卫生战略至关重要.
研究的目的:
- 调查药物敏感结核病患者中断治疗的特征,预测因素和后果.
- 确定与结核病治疗中断风险增加或降低相关的因素.
主要方法:
- 一项回顾性队列研究分析了马来西亚萨拉瓦克10家公共卫生诊所4年的结核病患者记录.
- 统计分析,包括奇平方,曼-惠特尼U,卡普兰-梅尔和考克斯比例危险回归,用于确定治疗中断的预测因素和结果.
主要成果:
- 在2953名患者中,有16.1%的患者经历了结核病治疗中断,最常见的是在前4周内的密集期.
- 药物不良反应 (aHR=8.53),吸烟 (aHR=2.67) 和非法药物使用 (aHR=1.88) 是中断的重要预测因素,而糖尿病显示出保护作用 (aHR=0.72).
- 治疗中断与更高的治疗重启率,药物变化,治疗持续时间的延长以及治疗成功结果显著降低 (86.5%与99.9%) 相关.
结论:
- 结核病治疗中断的时间模式,预测因素和负面后果明确定义.
- 研究结果强调需要及时干预和有针对性的策略,以减轻治疗中断和提高结核病治疗成功率.
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