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背景:1999年7月1日到2000年6月30日马拉维的所有非私立性医院(共43家)进行了结核病登记。目的:了解1)复发结核病的特点、管理以及治疗结局,2)上一次发生结核病的时间,以及3)登记复发涂阳肺结核病人的耐药情况。设计:根据结核病登记资料、实验室培养以及药敏实验的登记资料进行相关数据的回顾性收集。结果:共确定了748名复发患者;收集到其中747名患者的资料。其中,487例(65％)成功完成了复治方案,185人(25％)死亡,其余为其他结局。491名患者(66％)有以前患结核病的病史记录。上次治疗结束后2年或2年内开始复治者286人(58％)。 只有307名病人(41％)送痰标本进行培养及药敏试验检测。在培养分离出结核分枝杆菌的164名患者中,122例(81％)为敏感性病人,25例(15％)耐异烟肼和/或链霉素,6例(4％)耐异烟肼和利福平(MDR-TB)。结论:复发结核病患者的治疗结局尚可,大多数患者的病原体为敏感菌。半数以上的结核病复发发生在完成治疗后2年或2年内。需要对结核病复发的防治手段进行现场调研和实施。
Background: All non-self-administered hospitals in Malawi (43 in total) were registered for tuberculosis from 1 July 1999 to 30 June 2000. OBJECTIVES: To understand 1) the characteristics, management and treatment outcomes of recurrent tuberculosis, 2) the last time TB occurred, and 3) the registration of resistance in relapsed smear-positive pulmonary tuberculosis patients. Design: Retrospective collection of relevant data based on register data of tuberculosis registration, laboratory culture and susceptibility testing. Results: A total of 748 recurrent patients were identified; 747 of them were collected. Of these, 487 (65%) successfully completed the regimen, 185 (25%) died and the rest were other outcomes. 491 patients (66%) had previous history of tuberculosis. A total of 286 (58%) patients started retreatment within 2 years or 2 years after the last treatment. Only 307 patients (41%) were sputum specimens for culture and susceptibility testing. Of 164 patients with M. tuberculosis isolated, 122 (81%) were sensitive, 25 (15%) were resistant to isoniazid and / or streptomycin, and 6 (4%) resistant Hydrazide and rifampicin (MDR-TB). Conclusion: The treatment outcome of patients with recurrent tuberculosis is acceptable, and the pathogens of most patients are sensitive. More than half of tuberculosis recurrences occur within 2 or 2 years after completion of treatment. It is necessary to carry out on-site research and implementation on the means of prevention and treatment of tuberculosis relapse.