■营养不良与耐药结核病(DRTB)患者的不良治疗结果有关。影响营养不良患者治疗结果的因素没有得到很好的表征。这项研究的目的是确定与乌干达营养不良的DRTB患者治疗成功相关的因素。
我们分析了来自乌干达16个治疗地点的DRTB患者的回顾性队列数据。我们包括治疗前体重指数(BMI)<18.5千克/米2(kg/m2)的参与者。参与者被归类为轻度(BMI为18.5-17kg/m2),中度(BMI为16.9-16.0kg/m2)或重度(BMI<16.0kg/m2)营养不足。我们进行了逻辑回归分析,以确定与治疗成功相关的因素。
■在473名DRTB患者中,276例(58.4%)营养不良(BMI<18.5Kg/m2),纳入研究。其中,92(33.3%)轻度,69(25.0%)患有中度营养不足,115(41.7%)患有严重营养不足。营养不良患者的总体治疗成功率(TSR)为71.4%(n=197)。尽管轻度参与者的TSR相似(71.7%),中度(78.3%)和重度(67.0%)营养不足(p=0.258),所有治疗失败病例(n=6)均为严重营养不良患者(p=0.010).吸烟(优势比(OR)=0.19,95%CI0.07-0.47,p<0.001),城市居住地(OR=0.31,95%CI0.14~0.70,p=0.005),中度(OR=0.14,95%CI0.06~0.35,p<0.001)和重度贫血(OR=0.06,95%CI0.01~0.29,p=0.001)与较低的治疗成功率相关.
■大多数营养不良的DRTB患者存在严重的营养不良。吸烟和贫血是可改变的因素,经过适当的干预可以提高治疗成功率。城市居住对TSR的影响需要进一步评估。
UNASSIGNED: Undernutrition is associated with unfavourable treatment outcomes among people with drug-resistant tuberculosis (DRTB). Factors influencing the treatment outcomes among undernourished people with DRTB are not well characterised. The aim of this study was to determine factors associated with treatment success among undernourished people with DRTB in Uganda.
UNASSIGNED: We analysed data from a retrospective cohort of people with DRTB from 16 treatment sites in Uganda. We included participants with a pre-treatment body mass index (BMI) of <18.5 kilograms/meters2 (kg/m2). Participants were categorised as having mild (BMI of 18.5-17 kg/m2), moderate (BMI of 16.9-16.0 kg/m2) or severe (BMI of <16.0 kg/m2) undernutrition. We performed logistic regression analysis to determine factors associated with treatment success.
UNASSIGNED: Among 473 people with DRTB, 276 (58.4%) were undernourished (BMI < 18.5 Kg/m2) and were included in the study. Of these, 92 (33.3%) had mild, 69 (25.0%) had moderate and 115 (41.7%) had severe undernutrition. The overall treatment success rate (TSR) for the undernourished was 71.4% (n = 197). Although the TSR was similar among participants with mild (71.7%), moderate (78.3%) and severe (67.0%) undernutrition (p = 0.258), all treatment failure cases (n =6) were among participants with severe undernutrition (p = 0.010). Cigarette smoking (odds ratio (OR) = 0.19, 95% CI 0.07-0.47, p < 0.001), urban residence (OR = 0.31, 95% CI 0.14-0.70, p = 0.005) and moderate (OR = 0.14, 95% CI 0.06-0.35, p < 0.001) and severe anaemia (OR = 0.06, 95% CI 0.01-0.29, p = 0.001) were associated with lower odds of treatment success.
UNASSIGNED: Most undernourished people with DRTB have severe undernutrition. Smoking and anaemia are modifiable factors which upon appropriate intervention could improve treatment success. The effect of urban residence on the TSR needs to be evaluated further.