在乌干达加快结核病预防治疗扩展活动后结核病发病率
J Musaazi1, C Sekaggya-Wiltshire2, S Zawedde-Muyanja2
1Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda;, Global Health Institute, University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium.
概括
加快结核病预防疗法 (TPT) 运动显著降低了抗逆转录病毒疗法 (ART) 治疗艾滋病毒感染者 (PLHIV) 结核病发病率. 这突出了TPT的特点.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 艾滋病毒/艾滋病研究研究
背景情况:
- 乌干达在2019年7月至9月期间实施了一项加速结核病预防治疗 (TPT) 启动活动.
- 该研究重点关注这项运动对艾滋病毒感染者 (PLHIV) 接受抗逆转录病毒治疗 (ART) 的结核病 (TB) 发病率的影响.
- 对弱势群体的公共卫生干预措施的有效性进行评估对于疾病控制至关重要.
研究的目的:
- 评估加速TPT扩展活动对PLHIV的结核病发病率对乌干达的ART的影响.
- 量化TPT干预前后结核病风险的变化.
- 了解TPT作为PLHIV结核病控制战略的关键组成部分的作用.
主要方法:
- 一个准实验性的研究设计,利用例行收集的患者记录数据.
- 纳入标准:PLHIV年龄≥15岁,从2016年到2023年在六个公共卫生机构启动ART.
- 统计分析涉及逆概率治疗权重和Cox比例危险回归,以比较TB风险在TPT前后的扩大.
主要成果:
- 总共包括49,753名PLHIV患者,其中75%是女性,平均年龄为32岁.
- 在156,191个人年的随访中,记录了845个TB病例.
- 在战役后的3.5年里,结核病风险下降了25% (wHR为0.75,P=0.014),在各诊所存在差异,但不是性别.
结论:
- 加快TPT扩大规模的运动表明,在ART的PLHIV中,结核病发病率显著降低.
- 证实TPT是降低这一群体结核病发病率的重要和有效组成部分.
- 这些发现支持继续扩大并将TPT纳入艾滋病毒护理计划.
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