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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Effectiveness of Shorter Treatment Regimen in Multidrug-Resistant Tuberculosis Patients in Pakistan: A Multicenter Retrospective Record Review
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Effectiveness of Shorter Treatment Regimen in Multidrug-Resistant Tuberculosis Patients in Pakistan: A Multicenter Retrospective Record Review

机译：较短治疗方案在巴基斯坦多药抗结核患者中的效果：多中心回顾记录综述

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摘要

In Pakistan, the treatment of multidrug-resistant tuberculosis (MDR-TB) with a shorter treatment regimen (STR), that is, 4-6 months of amikacin, moxifloxacin (Mfx), ethionamide, clofazimine (Cfz), pyrazinamide (Z), ethambutol (E), and high-dose isoniazid, followed by 5 months of Mfx, Cfz, Z, and E, was initiated in 2018. However, there is a lack of information about its effectiveness in Pakistani healthcare settings. Therefore, this retrospective record review of MDR-TB patients treated with STR at eight treatment sites in Pakistan aimed to fill this gap. Data were analyzed using SPSS 23. Multivariate binary logistic regression (MVBLR) analysis was conducted to find factors associated with death and treatment failure, and lost to follow-up (LTFU). A P-value 0.05 was considered statistically significant. Of 912 MDR-TB patients enrolled at the study sites, only 313 (34.3%) eligible patients were treated with STR and included in the current study. Of them, a total of 250 (79.9%) were cured, 12 (3.8%) completed treated, 31 (9.9%) died, 16 (5.1%) were LTFU, and four (1.3%) were declared as treatment failures. The overall treatment success rate was 83.7%. In MVBLR analysis, patients' age of 41-60 (odds ratio [OR] = 4.9, P-value = 0.020) and 60 years (OR = 3.6, P-value = 0.035), being underweight (OR = 2.7, P-value = 0.042), and previous TB treatment (OR = 0.4, P-value = 0.042) had statistically significant association with death and treatment failure, whereas patients' age of > 60 years (OR = 5.4, P-value = 0.040) and previous TB treatment (OR = 0.2, P-value = 0.008) had statistically significant association with LTFU. The treatment success rate of STR was encouraging. However, to further improve the treatment outcomes, special attention should be paid to the patients with identified risk factors.
机译：在巴基斯坦，2018年开始采用较短的治疗方案（STR）治疗耐多药结核病（MDR-TB），即4-6个月的阿米卡星、莫西沙星（Mfx）、乙酰胺、氯法齐明（Cfz）、吡嗪酰胺（Z）、乙胺丁醇（E）和大剂量异烟肼，然后是5个月的Mfx、Cfz、Z和E。然而，关于其在巴基斯坦医疗环境中的有效性缺乏信息。因此，这项对巴基斯坦八个治疗点接受STR治疗的耐多药结核病患者的回顾性记录审查旨在填补这一空白。数据使用SPSS 23进行分析。进行多变量二元逻辑回归（MVBLR）分析，以发现与死亡和治疗失败以及失去随访（LTFU）相关的因素。P值0.05被认为具有统计学意义。在研究地点登记的912名耐多药结核病患者中，只有313名（34.3%）符合条件的患者接受了STR治疗，并纳入了本研究。其中，共有250例（79.9%）治愈，12例（3.8%）完成治疗，31例（9.9%）死亡，16例（5.1%）为LTFU，4例（1.3%）被宣布为治疗失败。总的治疗成功率为83.7%。在MVBLR分析中，41-60岁（优势比[OR]=4.9，P值=0.020）和60岁（OR=3.6，P值=0.035）、体重不足（OR=2.7，P值=0.042）和之前接受过结核病治疗（OR=0.4，P值=0.042）的患者与死亡和治疗失败有统计学显著关联，而年龄>60岁（OR=5.4，P值=0.040）和之前接受过结核病治疗（OR=0.2，P值=0.008）的患者与LTFU有统计学显著相关性。STR的治疗成功率令人鼓舞。然而，为了进一步改善治疗结果，应特别关注具有确定风险因素的患者。

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  • 作者

    Wahid Abudl; Ahmad Nafees; Ghafoor Abdul; Latif Abdullah; Saleem Fahad; Khan Shereen; Atif Muhammad; Iqbal Qaiser;

  • 作者单位

    Univ Balochistan Fac Pharm &

    Hlth Sci Dept Pharm Practice Sariab Rd Quetta 87300 Pakistan;

    Univ Balochistan Fac Pharm &

    Hlth Sci Dept Pharm Practice Sariab Rd Quetta 87300 Pakistan;

    Drug Resistant TB Natl TB Control Program Islamabad Pakistan;

    Drug Resistant TB Natl TB Control Program Islamabad Pakistan;

    Univ Balochistan Fac Pharm &

    Hlth Sci Dept Pharm Practice Sariab Rd Quetta 87300 Pakistan;

    Bolan Med Coll Dept Pulmonol Quetta Pakistan;

    Islamia Univ Bahawalpur Fac Pharm Dept Pharm Practice Bahawalpur Pakistan;

    Univ Balochistan Fac Pharm &

    Hlth Sci Dept Pharmaceut Quetta Pakistan;

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  • 正文语种 eng
  • 中图分类 地方病学;
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