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赞比亚医院结核病患者的死亡率:一项回顾性队列研究
Josphat Bwembya1,2, Ramya Kumar1,2, Victoria Musonda1
1Eradicate TB, PATH, Lusaka, Zambia.
PLOS global public health
|June 17, 2024
概括
在赞比亚,结核病 (TB) 的高死亡率仍然存在. 结核病治疗期间死亡的关键风险因素包括年龄,特定省份,某些医院类型,肺外结核病和艾滋病毒. 针对这些群体的干预措施至关重要.
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) 仍然是赞比亚死亡的一个重要原因,每年死亡人数约为15,000人.
- 高结核病死亡率需要了解治疗患者死亡的因素.
研究的目的:
- 在赞比亚接受结核病治疗的个体中确定死亡率的预测因素.
- 在这个患者群体中确定死亡时间和可能的死亡原因.
主要方法:
- 进行了一项全国性的回顾性队列研究,分析了2019年1月至12月期间在54家医院注册的10,987名结核病患者的医疗记录.
- 考克斯的比例危险模型被用来确定死亡率的独立风险因素.
主要成果:
- 在完成结核病治疗之前,患者的整体死亡率为9.7% (1,063例死亡).
- 大多数死亡 (75.7%) 发生在治疗的前两个月内,死亡的中位时间为21天.
- 死亡的独立风险因素包括晚年 (>54岁),特定的地理区域,医院级 (第三级/任务),非专家MTB/RIF诊断,肺外结核病 (EPTB) 和艾滋病毒联合感染.
结论:
- 在赞比亚,结核病治疗与高死亡率有关.
- 针对高风险群体的紧急干预,包括老年人,EPTB患者和艾滋病毒感染者,对于减少与结核病相关的死亡是必不可少的.
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