越南多药耐药结核病患者的长期结果:一个前性队列研究
Emily Lai-Ho MacLean1, Yen Ngoc Pham2, Cuong Duc Pham2
1NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney; Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW, 2050, Australia.
概括
对因利芬素或多药耐药结核病 (RR/MDR-TB) 接受治疗的患者的结局结果显示,死亡率和复发率高. 编程数据可能低估了真正的风险,强调了需要改进后续和监测的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 现有的死率和复发率对利法素或多药耐药结核病 (RR/MDR-TB) 可能被低估.
- 对于RR/MDR-TB患者的长期疾病结果需要彻底调查.
研究的目的:
- 确定治疗RR/MDR-TB的个人中长期死亡率和结核病复发率.
- 评估RR/MDR-TB结果的程序报告的准确性.
主要方法:
- 在越南进行了一项前性队列研究,患者开始使用世卫组织推的RR/MDR-TB疗法.
- 随访延长了≥32个月,调查了生命状况和随后的结核病发作.
- 标准化死亡率 (SMR) 用家庭接触者作为参考人群来计算.
主要成果:
- 1755名患者被录取;1364人在最终随访时被评估 (中位数为4.3年).
- 总体死亡率为42.6/1000人年,总体SMR为5.6.
- 结核病 (TB) 是96名参与者的死亡原因;43%的治疗死亡没有向国家结核病计划 (NTP) 报告.
- 随后的结核病发作率为10.3/1000人/年.
结论:
- 经过RR/MDR-TB的幸存者面临着死亡率和结核病复发的重大风险.
- 程序报告低估了治疗期间和治疗后的真实死亡率.
- 迫切需要加强对结核病复发的计划性后续行动和监测.
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