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Tüberküloz Hastalarında Tedavi Sonuçlarını Etkileyen Faktörler: Retrospektif Bir Kohort Çalışması

Yıl 2024, Cilt: 21 Sayı: 2, 306 - 313, 29.08.2024
https://doi.org/10.35440/hutfd.1446494

Öz

Amaç: Tüberküloz dünya çapında önde gelen on ölüm nedeninden biridir. Bu çalışmanın amacı TB has-talarında tedavi sonuçlarını incelemek ve tedavi başarısızlığı ile ilişkili faktörleri belirlemektir.
Materyal ve Metod: Bu çalışma, 2017-2021 yılları arasında Türkiye'nin Ordu ilinde gerçekleştirilen, retro-spektif, kayıt tabanlı bir kohort çalışmasıdır. Başarısız sonuçlarla ilişkili risk faktörlerini araştırmak için lojistik regresyon analizi kullanıldı.
Bulgular: Analize toplam 400 TB hastası dahil edildi. Gözlemlenen genel tedavi başarı oranı (TSR) (tedavi edilen veya tedavi tamamlanan) %87,7'dir (351). Hastaların 49’ unda (%12,3) başarısız tedavi sonucu elde edildi (ölüm, başarısızlık veya takip kaybı). Yaş>65 (olasılık oranı [OR] =12,2, %95 güven aralığı [CI] =4,03-36,85), erkek cinsiyet (OR = 2,2, %95 CI = 1,05-4,45) ve yabancı uyruklu olmak (OR = 9,2, %95 CI = 1,16-73,72) başarısız sonuçlarla ilişkili risk faktörleri olarak belirlendi (p<0,05).
Sonuç: Yaş>65, erkek cinsiyet ve yabancı uyruklu hastalar başarısız tedavi sonuçlarına sahip olma eğilimin-dedir. Bu özelliklerden herhangi birine sahip olan hastaların dikkatle izlenmesi ve özel önlemler alınması, başarısız tedavi sonuçlarının azaltılmasına yardımcı olabilir.

Kaynakça

  • 1. Floyd K, Glaziou P, Zumla A, Raviglione M. The global tuber-culosis epidemic and progress in care, prevention, and rese-arch: An overview in year 3 of the end TB era. Lancet Respir Med 2018;6:299‑314.
  • 2. World Health Organization. Global tuberculosis report 2020. https://www.who.int/publications-detail-redirect /9789240013131 (updated on 22 April 2022).
  • 3. Republic of Turkey Ministry of Health. The Guideline of Tuberculosis Diagnosis and Treatment 2019. Ankara Turkey. https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/dosya/Istatistikler/Yeni/4-Illere_Gore_Olgu_Hzlar_ve_TB_Insidans_2018.pdf (updated on 28 April 2022).
  • 4. Reid MJA, Arinaminpathy N, Bloom A, Bloom BR, Boehme C, Chaisson R et al. Building a tuberculosis-free world: The Lan-cet Commission on tuberculosis. Lancet 2019; 393(10178):1331–84.
  • 5. Sengul A, Akturk UA, Aydemir Y, Kaya N, Kocak ND, Tasolar FT. Factors affecting successful treatment outcomes in pul-monary tuberculosis: a single-center experience in Turkey, 2005-2011. J Infect Developing Countries. 2015;9(8):821–828.
  • 6. Republic of Turkey Ministry of Health. Tuberculosis active surveillance criteria. http://tuberkuloz.saglik.gov.tr (updated on 14 May 2022).
  • 7. World Health Organization. Implementing the end TB stra-tegy: the essentials. Geneva: WHO; 2015. https://www.who.int/tb/publications/2015/The_Essentials_to_End_TB/en/. (updated on 24 April 2022).
  • 8. Massavirov, S, Akopyan, K, Abdugapparov, F, Ciobanu A, Hovhanessyan A, Khodjaeva M et al. Risk Factors for Unfa-vorable Treatment Outcomes among the Human Immunode-ficiency Virus Associated Tuberculosis Population in Tashkent City, Uzbekistan: 2013–2017. Int. J. Environ. Res. Public He-alth 2021, 18, 4623.
  • 9. Min J, Kim JS, Kim HW, Shin AY, Koo HK, Lee SS et al. Clinical profiles of early and tuberculosis-related mortality in South Korea between 2015 and 2017: a cross-sectional study. BMC Infect Dis. 2019 Aug 22;19(1):735.
  • 10. Gebrezgabiher G, Romha G, Ejeta E, Asebe G, Zemene E, Ameni G. Treatment outcome of tuberculosis patients under directly observed treatment short course and factors affec-ting outcome in Southern Ethiopia: A five‑year retrospective study. PLoS One 2016;11:e0150560.
  • 11. Milanov V, Falzon D, Zamfirova M, Varleva T, Bachiyska E, Koleva A. Factors associated with treatment success and de-ath in cases with multidrug‑resistant tuberculosis in Bulga-ria, 2009‑2010. Int J Mycobacteriol 2015;4:131‑7.
  • 12. Republic of Turkey Ministry of Health. National Tuberculosis Control Program. https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/haberler/Ulusal_Tuberkuloz_Kontrol_Programi_-17_mart_2022/Ulusal_Tuberkuloz_Kontrol_Programi.pdf (updated on 17 May 2022).
  • 13. World Health Organization. Definitions and reporting framework for tuberculosis – 2013 revision: updated Decem-ber 2014 and January 2020. World Health Organization; 2013. https://apps.who.int/iris/handle/10665/79199 (up-dated on 5 May 2022).
  • 14. Babalik A, Kilicaslan Z, Kiziltas S, Gencer S, Ongen G. A retrospective case-control study, factors affecting treatment outcomes for pulmonary tuberculosis in Istanbul, Turkey. Balkan Med J 30: 204-210.
  • 15. Gadoev J, Asadov D, Tillashaykhov M, Tayler-Smith K, Isaaki-dis P, Dadu A et al. Factors associated with unfavorable tre-atment outcomes in new and previously treated TB patients in Uzbekistan: a five year countrywide study. PLoS One. 2015;10(6):e0128907. https://doi.org/10.1371/journal.pone.0128907.
  • 16. Khazaei S, Hassanzadeh J, Rezaeian S, Ghaderi E, Khazaei S, Hafshejani AM. Treatment outcome of new smear positive pulmonary tuberculosis patients in Hamadan, Iran: a re-gistry-based cross-sectional study. Egyptian J Chest Dis Tu-berc. 2016;65:825–30. https://doi.org/10.1016/j.ejcdt.2016.05.007.
  • 17. Ahmad T, Jadoon MA, Khan M, Haroon, Khan MM, Hussain A et al. Treatment outcomes of patients with tuberculosis in war affected region of Khyber Pakhtunkhwa, Pakistan. BMC Infect Dis. 2020 Jul 1;20(1):463.
  • 18. Talay F, Kumbetli S, Altin S. Factors associated with treat-ment success for tuberculosis patients: a single center's experience in Turkey. Jpn J Infect Dis 61: 25-30.
  • 19. Balasubramanian R, Garg R, Santha T, Gopi PG, Subramani R, Chandrasekaran V et al. Gender disparities in tuberculosis: report from a rural DOTS programme in south India. Int. J. Tuberc. Lung Dis., 8, 323–332.
  • 20. Falzon D, Le Strat Y, Belghiti F, Infuso A. Exploring the de-terminants of treatment success for tuberculosis cases in Europe. Int J Tuberc Lung Dis 9: 1224-1229.
  • 21. Macedo LR, Maciel ELN, Struchiner CJ. Vulnerable populati-ons and tuberculosis treatment outcomes in Brazil. Cien Sa-ude Colet. 2021 Oct;26(10):4749-4759.
  • 22. Babalik A, Kilicaslan Z, Caner SS, Gungor G, Ortakoylu MG, Gencer S et al. A registry-based cohort study of pulmonary tuberculosis treatment outcomes in Istanbul, Turkey. Jpn J Infect Dis 66: 115-120.
  • 23. Rajagopalan S. Tuberculosis in Older Adults. Clin Geriatr Med. 2016;32(3):479–491.
  • 24. Abebe G, Bonsa Z, Kebede W. Treatment outcomes and associated factors in tuberculosis patients at Jimma Univer-sity Medical Center: A 5-year retrospective study. Int J Myco-bacteriol. 2019 Jan-Mar;8(1):35-41.
  • 25. Oruç MA, Ozdemir S, Oztomurcuk D. Characteristics of tu-berculosis-related deaths and risk factors: a retrospective cohort study in Samsun province of Turkey. Postgrad Med. 2022 Mar;134(2):217-223.
  • 26. Jappar SB, Low SY. Tuberculosis trends over a five year pe-riod at a tertiary care university-affiliated hospital in Singa-pore. Singapore Med J 2015; 56(9): 502–505.
  • 27. Tahseen S, Khanzada FM, Baloch AQ, Abbas Q, Bhutto MM, Alizai AW et al. Extrapulmonary tuberculosis in Pakistan- A nation-wide multicenter retrospective study. PLoS One. 2020 Apr 28;15(4):e0232134.
  • 28. Filiz KA, Levent D, Emel E, Pelin U, Turkay A, Aybüke K. Characteristics of Active Tuberculosis Patients Requiring Intensive Care Monitoring and Factors Affecting Mortality. Tuberc Respir Dis (Seoul). 2016;79 (3):158– 164.
  • 29. Koh GC, Hawthorne G, Turner AM, Kunst H, Dedicoat M. Tuberculosis incidence correlates with sunshine: an eco-logical 28-year time series study. PLoS ONE 2013; 8(3): e57752.
  • 30. Luquero FJ, Sanchez-Padilla E, Simon-Soria F, Eiros JM, Golub JE. Trend and seasonality of tuberculosis in Spain, 1996-2004. Int J Tuberc Lung Dis 2008; 12(2): 221–224.
  • 31. Cayla JA, Rodrigo T, Ruiz-Manzano J, Caminero JA, Vidal R, García JM et al. Working Group on Completion of Tuberculo-sis Treatment in Spain (Study ECUTTE). Tuberculosis treat-ment adherence and fatality in Spain. Respir. Res., 10, 121.
  • 32. Mi F, Tan S, Liang L, Harries AD, Hinderaker SG, Lin Y et al. Diabetes mellitus and tuberculosis: pattern of tuberculosis, two-month smear conversion and treatment outcomes in Guangzhou, China. Trop Med Int Health 18: 1379-1385.

Factors Affecting Treatment Outcomes for Tuberculosis Patients: A Retrospective Cohort Study

Yıl 2024, Cilt: 21 Sayı: 2, 306 - 313, 29.08.2024
https://doi.org/10.35440/hutfd.1446494

Öz

Background: Tuberculosis (TB) is one of the ten leading causes of death globally. The present study aims to examine the treatment outcomes in TB patients and to determine the factors associated with unsuccessful treatment outcomes.
Materials and Methods: This study was a retrospective registry-based cohort study conducted in Ordu pro-vince of Turkey between 2017-2021. Logistic regression analysis was used to explore the risk factors asso-ciated with unsuccessful outcomes.
Results: A total of 400 TB patients were included in the analysis. The observed overall treatment success rate (TSR) (cured or treatment completed) was 87.7% (351). 49 patients (12.3%) had unsuccessful treatment results (death, failure or loss to follow-up). Age>65 years (odds ratio [OR] =12.2, 95% confidence intervals [CI] =4.03-36.85), male gender (OR = 2.2, 95% CI = 1.05-4.45) and being foreign-born (OR = 9.2, 95% CI = 1.16-73.72) were identified as risk factors associated with unsuccessful outcomes in patients (p<0.05).
Conclusions: Age>65 years, male gender and foreign-born patients tend to have unsuccessful treatment outcomes. Careful monitoring of patients with any of these characteristics and taking special precautions for them may help to decrease unsuccessful treatment outcomes.

Kaynakça

  • 1. Floyd K, Glaziou P, Zumla A, Raviglione M. The global tuber-culosis epidemic and progress in care, prevention, and rese-arch: An overview in year 3 of the end TB era. Lancet Respir Med 2018;6:299‑314.
  • 2. World Health Organization. Global tuberculosis report 2020. https://www.who.int/publications-detail-redirect /9789240013131 (updated on 22 April 2022).
  • 3. Republic of Turkey Ministry of Health. The Guideline of Tuberculosis Diagnosis and Treatment 2019. Ankara Turkey. https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/dosya/Istatistikler/Yeni/4-Illere_Gore_Olgu_Hzlar_ve_TB_Insidans_2018.pdf (updated on 28 April 2022).
  • 4. Reid MJA, Arinaminpathy N, Bloom A, Bloom BR, Boehme C, Chaisson R et al. Building a tuberculosis-free world: The Lan-cet Commission on tuberculosis. Lancet 2019; 393(10178):1331–84.
  • 5. Sengul A, Akturk UA, Aydemir Y, Kaya N, Kocak ND, Tasolar FT. Factors affecting successful treatment outcomes in pul-monary tuberculosis: a single-center experience in Turkey, 2005-2011. J Infect Developing Countries. 2015;9(8):821–828.
  • 6. Republic of Turkey Ministry of Health. Tuberculosis active surveillance criteria. http://tuberkuloz.saglik.gov.tr (updated on 14 May 2022).
  • 7. World Health Organization. Implementing the end TB stra-tegy: the essentials. Geneva: WHO; 2015. https://www.who.int/tb/publications/2015/The_Essentials_to_End_TB/en/. (updated on 24 April 2022).
  • 8. Massavirov, S, Akopyan, K, Abdugapparov, F, Ciobanu A, Hovhanessyan A, Khodjaeva M et al. Risk Factors for Unfa-vorable Treatment Outcomes among the Human Immunode-ficiency Virus Associated Tuberculosis Population in Tashkent City, Uzbekistan: 2013–2017. Int. J. Environ. Res. Public He-alth 2021, 18, 4623.
  • 9. Min J, Kim JS, Kim HW, Shin AY, Koo HK, Lee SS et al. Clinical profiles of early and tuberculosis-related mortality in South Korea between 2015 and 2017: a cross-sectional study. BMC Infect Dis. 2019 Aug 22;19(1):735.
  • 10. Gebrezgabiher G, Romha G, Ejeta E, Asebe G, Zemene E, Ameni G. Treatment outcome of tuberculosis patients under directly observed treatment short course and factors affec-ting outcome in Southern Ethiopia: A five‑year retrospective study. PLoS One 2016;11:e0150560.
  • 11. Milanov V, Falzon D, Zamfirova M, Varleva T, Bachiyska E, Koleva A. Factors associated with treatment success and de-ath in cases with multidrug‑resistant tuberculosis in Bulga-ria, 2009‑2010. Int J Mycobacteriol 2015;4:131‑7.
  • 12. Republic of Turkey Ministry of Health. National Tuberculosis Control Program. https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/haberler/Ulusal_Tuberkuloz_Kontrol_Programi_-17_mart_2022/Ulusal_Tuberkuloz_Kontrol_Programi.pdf (updated on 17 May 2022).
  • 13. World Health Organization. Definitions and reporting framework for tuberculosis – 2013 revision: updated Decem-ber 2014 and January 2020. World Health Organization; 2013. https://apps.who.int/iris/handle/10665/79199 (up-dated on 5 May 2022).
  • 14. Babalik A, Kilicaslan Z, Kiziltas S, Gencer S, Ongen G. A retrospective case-control study, factors affecting treatment outcomes for pulmonary tuberculosis in Istanbul, Turkey. Balkan Med J 30: 204-210.
  • 15. Gadoev J, Asadov D, Tillashaykhov M, Tayler-Smith K, Isaaki-dis P, Dadu A et al. Factors associated with unfavorable tre-atment outcomes in new and previously treated TB patients in Uzbekistan: a five year countrywide study. PLoS One. 2015;10(6):e0128907. https://doi.org/10.1371/journal.pone.0128907.
  • 16. Khazaei S, Hassanzadeh J, Rezaeian S, Ghaderi E, Khazaei S, Hafshejani AM. Treatment outcome of new smear positive pulmonary tuberculosis patients in Hamadan, Iran: a re-gistry-based cross-sectional study. Egyptian J Chest Dis Tu-berc. 2016;65:825–30. https://doi.org/10.1016/j.ejcdt.2016.05.007.
  • 17. Ahmad T, Jadoon MA, Khan M, Haroon, Khan MM, Hussain A et al. Treatment outcomes of patients with tuberculosis in war affected region of Khyber Pakhtunkhwa, Pakistan. BMC Infect Dis. 2020 Jul 1;20(1):463.
  • 18. Talay F, Kumbetli S, Altin S. Factors associated with treat-ment success for tuberculosis patients: a single center's experience in Turkey. Jpn J Infect Dis 61: 25-30.
  • 19. Balasubramanian R, Garg R, Santha T, Gopi PG, Subramani R, Chandrasekaran V et al. Gender disparities in tuberculosis: report from a rural DOTS programme in south India. Int. J. Tuberc. Lung Dis., 8, 323–332.
  • 20. Falzon D, Le Strat Y, Belghiti F, Infuso A. Exploring the de-terminants of treatment success for tuberculosis cases in Europe. Int J Tuberc Lung Dis 9: 1224-1229.
  • 21. Macedo LR, Maciel ELN, Struchiner CJ. Vulnerable populati-ons and tuberculosis treatment outcomes in Brazil. Cien Sa-ude Colet. 2021 Oct;26(10):4749-4759.
  • 22. Babalik A, Kilicaslan Z, Caner SS, Gungor G, Ortakoylu MG, Gencer S et al. A registry-based cohort study of pulmonary tuberculosis treatment outcomes in Istanbul, Turkey. Jpn J Infect Dis 66: 115-120.
  • 23. Rajagopalan S. Tuberculosis in Older Adults. Clin Geriatr Med. 2016;32(3):479–491.
  • 24. Abebe G, Bonsa Z, Kebede W. Treatment outcomes and associated factors in tuberculosis patients at Jimma Univer-sity Medical Center: A 5-year retrospective study. Int J Myco-bacteriol. 2019 Jan-Mar;8(1):35-41.
  • 25. Oruç MA, Ozdemir S, Oztomurcuk D. Characteristics of tu-berculosis-related deaths and risk factors: a retrospective cohort study in Samsun province of Turkey. Postgrad Med. 2022 Mar;134(2):217-223.
  • 26. Jappar SB, Low SY. Tuberculosis trends over a five year pe-riod at a tertiary care university-affiliated hospital in Singa-pore. Singapore Med J 2015; 56(9): 502–505.
  • 27. Tahseen S, Khanzada FM, Baloch AQ, Abbas Q, Bhutto MM, Alizai AW et al. Extrapulmonary tuberculosis in Pakistan- A nation-wide multicenter retrospective study. PLoS One. 2020 Apr 28;15(4):e0232134.
  • 28. Filiz KA, Levent D, Emel E, Pelin U, Turkay A, Aybüke K. Characteristics of Active Tuberculosis Patients Requiring Intensive Care Monitoring and Factors Affecting Mortality. Tuberc Respir Dis (Seoul). 2016;79 (3):158– 164.
  • 29. Koh GC, Hawthorne G, Turner AM, Kunst H, Dedicoat M. Tuberculosis incidence correlates with sunshine: an eco-logical 28-year time series study. PLoS ONE 2013; 8(3): e57752.
  • 30. Luquero FJ, Sanchez-Padilla E, Simon-Soria F, Eiros JM, Golub JE. Trend and seasonality of tuberculosis in Spain, 1996-2004. Int J Tuberc Lung Dis 2008; 12(2): 221–224.
  • 31. Cayla JA, Rodrigo T, Ruiz-Manzano J, Caminero JA, Vidal R, García JM et al. Working Group on Completion of Tuberculo-sis Treatment in Spain (Study ECUTTE). Tuberculosis treat-ment adherence and fatality in Spain. Respir. Res., 10, 121.
  • 32. Mi F, Tan S, Liang L, Harries AD, Hinderaker SG, Lin Y et al. Diabetes mellitus and tuberculosis: pattern of tuberculosis, two-month smear conversion and treatment outcomes in Guangzhou, China. Trop Med Int Health 18: 1379-1385.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Bulaşıcı Hastalıklar, Göğüs Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Feyza Nur Topçu Yenerçağ 0000-0003-1355-9607

Fatih Aydın 0000-0001-5841-911X

Erken Görünüm Tarihi 26 Ağustos 2024
Yayımlanma Tarihi 29 Ağustos 2024
Gönderilme Tarihi 10 Mart 2024
Kabul Tarihi 17 Ağustos 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 21 Sayı: 2

Kaynak Göster

Vancouver Topçu Yenerçağ FN, Aydın F. Factors Affecting Treatment Outcomes for Tuberculosis Patients: A Retrospective Cohort Study. Harran Üniversitesi Tıp Fakültesi Dergisi. 2024;21(2):306-13.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty