所有结核病死亡是否正确地归因于结核病? 使用口头尸检对死亡原因 (COD) 的分析:普杜切里的一个横截面研究
Reenaa Mohan1, M Rajalakshmi1, G Kalaiselvan2
1Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.
Journal of family medicine and primary care
|February 24, 2025
概括
声明结核病 (TB) 死亡的很大一部分不是由TB引起的. 这项口头尸检研究强调了对结核病患者死亡原因的准确确定的需要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医学研究 医学研究
背景情况:
- 国家消除结核病计划 (NTEP) 要求准确的结核病 (TB) 死亡率数据.
- 确定结核病患者死亡的确切原因对于有效的公共卫生干预至关重要.
研究的目的:
- 通过口头解剖来确定被诊断患有结核病 (TB) 的人死亡的实际原因.
- 评估结核病死亡报告的准确性,并确定差异.
主要方法:
- 一项基于社区的横截面研究,使用口头尸检问卷给已故结核病患者的护理人员.
- 由两名经过培训的教师使用国际疾病分类 - 第10版 (ICD-10) 进行死亡原因的独立审查和编码.
- 统计分析包括科恩的卡帕 (Cohen's kappa) 对于评价者间的协议,以及用于预测准确性的接收运营商曲线 (ROC) 分析.
主要成果:
- 在143例接触过的结核病死亡病例中,发现34.9%的死亡病例不是由于结核病.
- 观察到评级者之间存在中度的一致性 (科恩的卡帕=0.4).
- 专家评审者实现了高预测准确度 (AUC>0.94对于两个评审者).
结论:
- 由于结核病而导致的大量死亡人数并不是直接由该疾病引起的.
- 口头解剖是澄清结核病患者死亡原因的宝贵工具.
- 这些发现强调了结核病控制计划中严格确定死因的重要性.
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