結核予防治療の実施:インドにおける大規模な取り組みからの教訓
M Das1, A Kalra1, A S ThekkePurakkal1
1FIND, New Delhi, India.
まとめ
3ヶ月のリファペンチン・アイソニアジド (3HP) 療法は,家庭の接触者間で結核予防治療 (TPT) の完了率が高いことを示しています. 標準の6ヶ月のイソニアジド療法と比較して,この短いTPTオプションは管理可能な有害事象と優れたアデランスを示しました.
科学分野:
- 公衆衛生
- 感染症
- 臨床試験
背景:
- 結核 (TB) は,依然として世界的な健康問題です.
- 短期間での結核予防治療 (TPT) は,WHOによってますます推奨されています.
- インドの結核撲滅のための共同取り組み (JEET) プロジェクトでは,新しいTPT戦略を評価しています.
研究 の 目的:
- 3ヶ月のリファペンチン・イソニアジド (3HP) 療法による結核予防治療の早期実施結果を評価する.
- 3HPの特性,有害事象,および治療結果を標準的な6ヶ月のイソニアジド (6H) レジメントと比較する.
- 3HPの実用性を評価する.
主な方法:
- 肺結核患者の家庭接触者 (HHC) を対象に記述的なコホート研究が行われました.
- HHCは,選択された地区で3HPまたは6H TPTを受け取った.
- HHCの特徴,有害事象,TPTの完了に関するデータを収集し,両グループ間で比較した.
主要な成果:
- 3HPで合計635のHHCが開始され,24,350のHHCが6Hを受けた.
- 3HPでは約10%のHHCが有害事象を経験し,6Hでは4%でした.
- 6H (84%,P < 0. 001) と比較すると,TPT完了率は3HP (95%) よりも著しく高かった.
結論:
- 3HP療法は,管理可能な有害事象の発生率を低く,高いTPT完了率を達成しました.
- これらの発見は,国家TBプログラム内の3HP療法の拡大を支持しています.
- 3HPは結核の負担が大きい国々にとって 有望で効果的な 短期間のTPTの選択肢です
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