关键词: 结核,肺, 分枝杆菌,结核, 治疗效果, 因素分析,统计学, 宁夏[回族自治区]

Abstract:

Objective: By analyzing the epidemiology and influencing factors of treatment outcomes among bacteriologically positive pulmonary tuberculosis patients in Ningxia Hui Autonomous Region from 2019 to 2023, to provide epidemiological evidence for enhancing tuberculosis prevention and control efforts. Methods: The anti-tuberculosis treatment data and treatment outcomes of bacteriologically confirmed pulmonary tuberculosis patients registered in Ningxia from 2019 to 2023 were exported from the “Infectious Disease Surveillance Management System”, a subsystem of the “China Information System for Disease Control and Prevention”. Univariate and multivariate binary logistic regression analyses were used to identify influencing factors of treatment outcomes. Results: From 2019 to 2023, the treatment success rate for bacteriologically confirmed pulmonary tuberculosis (PTB) patients was 93.16% (5175/5555). Notably, the year 2023 achieved the highest success rate at 95.63% (1203/1258). Among unfavorable outcomes, mortality accounted for the highest proportion at 4.15% (231/5555). The treatment success rate demonstrated a statistically significant upward trend across years ($\chi_{\text {trend }}^2$=1864.000, P<0.01). Univariate analysis showed that the treatment success rate of male PTB patients (91.54%,2544/2779) was lower than that of female patients (94.78%,2631/2776), and male patients experienced higher unfavorable outcomes (8.46%,235/2779) than females (5.22%,145/2776). Patients aged above 75 years achieved the lowest treatment success rate (87.69%,1183/1349) and highest unfavorable outcome rate (12.31%,166/1349). Occupational variations were observed, with retirees (12.97%,52/401), housework and unemployed individuals (7.84%,91/1161), and farmers (6.86%,218/3177) showing higher unfavorable outcomes than other occupation groups.The unfavorable outcomes of retreated cases (10.20%,36/353)were higher than that of initial treated patients (6.61%,344/5202). Gender, age, occupation and treatment type all had an impact on both the treatment success and unfavorable outcomes, and the differences were statistically significant (P<0.01). The results of the multivariate logistic regression analysis showed that male patients had a 1.559 times higher risk of poor treatment outcomes compared to female patients (OR=1.559, 95%CI: 1.311-1.853). Patients in the 0-14 age group had a lower risk of poor treatment outcomes than those among ≥75 age group (OR=0.318, 95%CI: 0.039-2.570). Initial treated patients had a lower risk of poor treatment outcomes than retreated patients (OR=0.351, 95%CI: 0.276-0.446). Conclusion: Tuberculosis (TB) prevention and control in Ningxia has achieved significant results. However, certain populations including males, the elderly, retreatment cases, as well as some occupation groups such as retirees, housework and unemployed individuals, and farmers, still face a higher risk of poor treatment outcomes.

Key words: Tuberculosis,pulmonary, Mycobacterium tuberculosis, Treatment outcome, Factor analysis, statistical, Ningxia Hui Autonomous Region