引入乙醇和将药物整合到固剂片中对结核病患者死亡率的影响
Fredi Alexander Diaz-Quijano1, Patricia Bartholomay2, Kleydson Bonfim Andrade2
1Department of Epidemiology, Laboratory of Causal Inference in Epidemiology - LINCE-USP, School of Public Health, University of São Paulo, São Paulo, SP 01246-904, Brazil.
Transactions of the Royal Society of Tropical Medicine and Hygiene
|September 22, 2025
概括
巴西 巴西 巴西 巴西.
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
- 临床试验分析
背景情况:
- 2009年,巴西的结核病 (TB) 治疗方案发生了变化,因异化耐药性增加.
- 修改后的治疗方案包括乙醇,固定剂量组合和调整剂量.
- 这项研究评估了这种治疗方案修改对患者结局的影响.
研究的目的:
- 评估巴西修改的结核病治疗方案对所有原因死亡率的影响.
- 第二次检查结核病特异性死亡率,治疗成功率和对随访的损失.
主要方法:
- 分析了两大群体 (n=145,528变换前,n=161,264变换后) 的结核病患者,年龄≥10岁.
- 使用了国家可报告的疾病和死亡率数据,并对缺失的值进行了归算.
- 采用多层逻辑回归模型,控制通过指向非循环图识别的共变量.
主要成果:
- 治疗方案的改变与全因死亡率 (RR 1.01) 或结核病特定死亡率 (RR 0.98) 没有显著的关联.
- 在改变后观察到治疗成功率下降和随访损失增加.
- 敏感性分析显示了与转移数据处理和缺失结果相关的潜在解释.
结论:
- 巴西更新的结核病治疗方案并没有对患者的存活率产生负面影响.
- 对数据管理实践的进一步调查可能会澄清治疗成功和随访的观察到的变化.
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