埃斯瓦提尼的结核病和糖尿病:通过综合服务解决不理想的治疗结果
Yael Hirsch-Moverman1,2, Dana Bezuidenhout1,2, Sakthi Senthilvelan3
1ICAP at Columbia University, Mailman School of Public Health, New York, United States of America.
PLOS global public health
|May 29, 2025
概括
糖尿病 (DM) 在埃斯瓦提尼显著恶化结核病 (TB) 治疗结果. 早期查和综合护理对于管理同时发生的结核病和DM至关重要,特别是考虑到高患病率.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 内分泌学 在内分泌学.
背景情况:
- 结核病 (TB) 是埃斯瓦提尼 (Eswatini) 的一个主要的公共卫生问题,因世界上艾滋病毒感染率最高而加剧.
- 糖尿病 (DM) 在结核病患者中越来越多地被诊断为糖尿病,导致治疗结果较差,如复发和死亡率.
研究的目的:
- 为了确定在埃斯瓦提尼的结核病成年人中DM的流行率.
- 评估DM对结核病治疗结果的影响.
- 探索结核病和DM服务整合的障碍和促进因素.
主要方法:
- 使用了多种方法的方法,包括用于DM查的糖化血红蛋白 (A1c) 测试.
- 逻辑回归分析了DM和结核病治疗结果之间的关联.
- 与40个利益相关者进行了深入采访,探讨了服务整合的挑战.
主要成果:
- 在373名结核病患者中,13.4%患有DM,41.8%患有糖尿病前期,44.8%的A1c水平正常.
- DM与不良结核病治疗结果的概率高3.53倍,无论艾滋病毒状况如何.
- 促进整合的因素包括患者教育和资源;障碍包括财务限制和提供者培训.
结论:
- 在埃斯瓦提尼的结核病人口中,DM/糖尿病前期的患病率很高.
- 糖尿病显著增加结核病治疗不良结果的风险.
- 综合性TB/DM服务需要加强策略和对医疗保健提供者的支持.
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