Managing Comorbidities, Determinants and Disability at Start and End of TB Treatment under Routine Program Conditions in China

Tropical Medicine and Infectious Disease

article

Yuhong Liu¹  Yan Lin³  Yuxian Sun¹  Pruthu Thekkur³  Changhao Cheng⁵  Yuecui Li⁶  Yunzhen Shi⁷  Jun Jiang⁸  Jiong Liao⁹  Chuangui Nie^1,10  Wenyan Sun^1,11  Chengyuan Liang^1,12  Xiaojuan Zhang^1,13  Sang Liu^1,14  Yan Ma^1,15  Selma Dar Berger³  Srinath Satyanarayana³  Ajay M. V. Kumar³  Mohammed Khogali^1,17  Rony Zachariah^1,18  Jonathan E. Golub^1,19  Liang Li¹  Anthony D. Harries³ 

[1] Beijing Chest Hospital, Capital Medical University;Beijing Tuberculosis and Thoracic Tumor Research Institute;International Union Against Tuberculosis and Lung Disease;The Union South-East Asia Office, C-6 Qutub Institutional Area;Wuhan Pulmonary Hospital;The First People’s Hospital of Yongkang;Dongyang People’s Hospital;The Third People’s Hospital of Yichang City;The People’s Hospital of Laiban;Xiangyang Institute of Tuberculosis Control and Prevention;Ezhou Third Hospital;Baise City People’s Hospital;Zhongwei People’s Hospital;Guangxi Chest Hospital;The People’s Hospital of Tongxin;Yenepoya Medical College, Yenepoya ,(Deemed to be University);Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University;UNICEF, UNDP, World Bank, World Health Organization, Special Programme for Research and Training in Tropical Diseases;Johns Hopkins Center for Tuberculosis, Johns Hopkins University School of Medicine;Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine

关键词: tuberculosis;    China;    diabetes mellitus;    high blood pressure;    mental health disorder;    cigarette smoking;    excess alcohol drinking;    SORT IT;    6 min walking test;    disability;   

DOI  :  10.3390/tropicalmed8070341

学科分类：社会科学、人文和艺术（综合）

来源: mdpi

【 摘 要 】

Many patients with tuberculosis (TB) have comorbidities, risk determinants and disability that co-exist at diagnosis, during and after TB treatment. We conducted an observational cohort study in 11 health facilities in China to assess under routine program conditions (i) the burden of these problems at the start and end of TB treatment and (ii) whether referral mechanisms for further care were functional. There were 603 patients registered with drug-susceptible TB who started TB treatment: 84% were symptomatic, 14% had diabetes, 14% had high blood pressure, 19% smoked cigarettes, 10% drank excess alcohol and in 45% the 6 min walking test (6MWT) was abnormal. Five patients were identified with mental health disorders. There were 586 (97%) patients who successfully completed TB treatment six months later. Of these, 18% were still symptomatic, 12% had diabetes (the remainder with diabetes failed to complete treatment), 5% had high blood pressure, 5% smoked cigarettes, 1% drank excess alcohol and 25% had an abnormal 6MWT. Referral mechanisms for the care of comorbidities and determinants worked well except for mental health and pulmonary rehabilitation for disability. There is need for more programmatic-related studies in other countries to build the evidence base for care of TB-related conditions and disability.

【 授权许可】

CC BY