2015年至2022年间巴西的再治疗和抗结核治疗结果:全国性研究
Beatriz Barreto-Duarte1,2,3,4,5, Klauss Villalva-Serra1,3, João P Miguez-Pinto1,3
1Curso de Medicina, Universidade Salvador, Salvador, Brazil.
Open forum infectious diseases
|August 5, 2024
概括
在巴西,因结核病 (TB) 退院的患者面临着糟糕的结果,特别是在失去随访后 (LTFU). 有针对性的干预措施对于提高抗结核治疗 (ATT) 成功率和实现世卫组织目标至关重要.
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:
- 巴西对抗结核病治疗 (ATT) 的坚持是一个重大挑战.
- 在治疗期间失去随访的患者 (LTFU) 是一个主要的公共卫生问题.
- 实现世界卫生组织 (WHO) 的治疗目标仍然很困难.
研究的目的:
- 调查与不利的ATT结果相关的因素.
- 专门分析在巴西接受再治疗的患者的结果.
主要方法:
- 2015-2022年结核病 (TB) 患者 (≥18岁) 的观察性研究.
- 新病例与再治疗病例之间的临床和流行病学变量比较.
- 回归模型用于识别与不利结果相关的变量.
主要成果:
- 在失去了随访后 (RLTFU) 重新治疗显著增加了不利的ATT结果的风险 (OR,3.96).
- RLTFU是随后LTFU的主要风险因素 (OR,4.93).
- 携带艾滋病毒是导致死亡的主要危险因素 (OR,6.28),除了晚年.
结论:
- 重新治疗,特别是在LTFU之后,是不利的ATT结果的主要风险因素.
- 对RLTFU的治疗成功率远远低于世卫组织在巴西的结核病终结战略目标.
- 有针对性的干预措施对于提高RLTFU患者的治疗坚持和治疗结果至关重要.
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