สถานการณ์วัณโรคและปัจจัยที่มีผลต่อการรักษาวัณโรคครบในโรงพยาบาลสงฆ์ พ.ศ. 2547-2549

Abstract

Background: Tuberculosis is a public health problem of Thailand. There were a lot of monks with tuberculosis who  came to receive treatment from Priest Hospital. Some of them received incomplete treatment and made the tubercle  bacilli resistant to the drugs. Objective: To study tuberculosis situation treatment outcomes and factors affecting  complete treatment in Priest Hospital. Methodology: The data were collected during 2004 - 2006 from medical records which were diagnosed tuberculosis at Priest Hospital. SPSS for Window version 11 computer program  was used for data analysis. Statistical analysis: The descriptive statistics were used for analysis of single variable. The multiple logistic   egression was used for analysis of the correlation of variables. Results: There were 255 cases of tuberculosis  in this study. The age ranged from 20 to 95 years with mean age of 55 ± 17.2 years. There were more  than 50 years of age ( 60.8%) finished elementary level of education (71.8%) lived in central region (43.1%) and  suffered from pulmonary tuberculosis (79.2%). Chest radiographs were performed in 50.6% and the most  common results were unilateral upper lung infiltration (25.6%). The sputum examinations were done among58 %  and positive results revealed 29.7 % of the examined samples. There was 43.5 % of the patients who had comorbidities which the common ones were HIV infection (13.7 %) and diabetes mellitus (12.5 %). Most of the patients (60.0%) were treated with Cat 1 antituberculous drug regimen. The side effects of drugs were found in 12.6%  of cases and the most common one was hepatitis (10.2%). The percentages of complete treatments incomplete treatments       deaths and referrals were 33.3, 32.2, 8.2 and 13.7 respectively.   The factor which promoted complete treatment significantly was diabetes comorbidity (OR = 4.07) and the resisted one was southeastern regionresidence  (OR = 0.24). Conclusions: Most of tuberculosis patients of Priest Hospital were more than 50 years of age resided in central region and Bangkok The promoting factor for complete treatment was diabetes comorbidity and the resisting one was southeastern region residence. These results were beneficial for development of  more  effective care for the monks suffering from tuberculosis.