结核病和结核病复发的人口和临床决定因素:巴基斯坦的一项双刃回顾性研究。

IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Tropical Medicine Pub Date : 2022-11-28 eCollection Date: 2022-01-01 DOI:10.1155/2022/4408306
Mariam Ahmed Mujtaba, Matthew Richardson, Hira Shahzad, Muhammad Ishaq Javed, Ghazala Kaukab Raja, Pakeeza Arzoo Shaiq, Pranabashis Haldar, Sadia Saeed
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引用次数: 0

摘要

目的:结核病复发是指初次治疗后的第二次结核病发作,结核病负担增加了 7%,耐多药复发病例增加了 17.7%。有必要遏制复发,以便更有效地治疗活动性疾病。本研究旨在描述在高负担环境中与结核病复发相关的社会人口和临床因素。研究方法在巴基斯坦拉瓦尔品第的两家医院开展了一项回顾性病例对照研究。研究对象包括肺结核患者和对照组。通过问卷调查收集了所有受试者的社会人口学和临床数据。研究人员分别对肺结核和肺结核复发的相关因素进行了多变量回归分析:在我们的研究队列中,与肺结核明显相关的因素有低体重指数(OR:0.961 (CI 0.954-0.968),P < 0.001)、女性性别(OR:2.065 (CI 1.922-2.219),P < 0.001)、单身/未婚(OR:1.214(CI 1.109-1.328),p=0.003)、中等收入状况(OR:1.935(CI 1.616-2.323),p<0.001)、吸烟(OR:1.567(CI 1.435-1.710),p<0.001)和糖尿病(OR:1.142(CI 1.017-1.278),p=0.023)。肺结核复发患者占入院患者的 11.2%。与首次发病的肺结核患者相比,复发病例的年龄更大(OR:1.011 (CI 1.004-1.017),P <0.001)、对疾病有认识(OR:1.906(CI 1.486-2.437),P<0.001)、涂片阳性(OR:2.384(CI 1.650-3.536),P<0.001)和耐药(OR:5.615(CI 4.265-7.386),P<0.001):在本研究队列中,低体重指数、女性性别、单身、中等收入、失业、吸烟和糖尿病是结核病的社会人口学和临床风险因素。进一步研究发现,尽管人们对结核病的认识很高,但结核病病例的年龄增长、耐药性和涂片阳性是结核病复发的主要社会人口和临床因素。
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Demographic and Clinical Determinants of Tuberculosis and TB Recurrence: A Double-Edged Retrospective Study from Pakistan.

Objective: TB recurrence is the second episode of TB after initial treatment bringing about an additional 7% load in TB burden intensified by 17.7% of multidrug-resistant recurrent cases. It is necessary to curb recurrence so that attempts to deal with active disease can be made more effective. This study aimed to characterize sociodemographic and clinical factors associated with recurrent TB in a high-burden setting. Methodology. A retrospective case-control study was carried out at two hospitals in Rawalpindi, Pakistan. TB patients and controls were included in the study. Sociodemographic and clinical data were collected by questionnaire from all subjects. Multivariate regression analysis was performed to determine factors associated with TB and TB recurrence respectively.

Results: In our study cohort, factors significantly associated with TB were low BMI (OR: 0.961 (CI 0.954-0.968), p < 0.001), female gender (OR: 2.065 (CI 1.922-2.219), p < 0.001), being single/unmarried (OR: 1.214 (CI 1.109-1.328), p=0.003), middle-income status (OR: 1.935 (CI 1.616-2.323), p < 0.001), smoking (OR: 1.567 (CI 1.435-1.710), p < 0.001), and diabetes mellitus (OR: 1.142 (CI 1.017-1.278), p=0.023). TB recurrence constituted 11.2% of patients presenting to the hospital. Compared with the first episode of TB, cases with recurrence were more likely to be older (OR: 1.011 (CI 1.004-1.017), p < 0.001), have disease awareness (OR: 1.906 (CI 1.486-2.437), p < 0.001), smear positive (OR: 2.384 (CI 1.650-3.536), p < 0.001), and be drug-resistant (OR: 5.615 (CI 4.265-7.386), p < 0.001).

Conclusion: In the present study cohort, low BMI, female gender, being single, middle-income status, being unemployed, smoking, and being diabetic came out to be the sociodemographic and clinical risk factors for TB. Further exploring the TB cases increasing age, drug resistance and smear positivity stood out to be the major sociodemographic and clinical factors of TB recurrence despite high disease awareness.

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来源期刊
Journal of Tropical Medicine
Journal of Tropical Medicine Immunology and Microbiology-Parasitology
CiteScore
3.90
自引率
4.50%
发文量
0
审稿时长
14 weeks
期刊介绍: Journal of Tropical Medicine is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies on all aspects of tropical diseases. Articles on the pathology, diagnosis, and treatment of tropical diseases, parasites and their hosts, epidemiology, and public health issues will be considered. Journal of Tropical Medicine aims to facilitate the communication of advances addressing global health and mortality relating to tropical diseases.
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