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评估现金转移对结核病的影响 (ExaCT TB):一个阶梯集群随机对照试验
Priya B Shete1, Jillian L Kadota1, Grace Nanyunja2
1Center for Tuberculosis and Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, CA, USA.
ERJ open research
|June 21, 2023
概括
乌干达的一项现金转移干预改善了结核病 (TB) 检测的完成,但并没有显著增加治疗的开始. 该研究强调,虽然财政援助有所帮助,但它可能无法完全克服结核病诊断和治疗的社会经济障碍.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 传染病流行病学 传染病流行病学
背景情况:
- 在全球范围内,金融障碍严重阻碍了结核病 (TB) 的诊断和治疗.
- 解决这些社会经济决定因素是全球结核病应对行动的关键优先事项.
- 本研究评估了乌干达的一项现金转移干预措施,以缓解金融障碍.
研究的目的:
- 评估一次性无条件现金转账对结核病检测完成和治疗启动的影响.
- 了解金融激励措施在克服结核病护理社会经济障碍方面的有效性.
- 在务实,现实世界的程序设置中评估结果.
主要方法:
- 在乌干达的10个健康中心进行了一项务实的完全阶段形随机试验.
- 符合条件的个人转到基于唾液的结核病检测,在唾液提交时收到现金转账 (UGX 20,000).
- 主要结局:在两周内开始治疗微生物学确认的结核病;使用负二项回归分析.
主要成果:
- 干预显著增加了结核病检测转诊率 (aRR=2.60) 和结核病检测完成率 (aRR=3.22).
- 虽然在干预期内诊断出结核病并开始治疗的人数较多 (aRR=1.34),但这在统计学上并不显著 (p=0.46).
- 调查数据显示,现金转移支持测试完成,但不足以解决潜在的长期社会经济障碍.
结论:
- 一个单一的无条件现金转移干预表明,在程序性环境中对结核病诊断评估的完成产生了积极影响.
- 由于结果不显著,干预对增加结核病诊断和治疗的人数的影响仍然不确定.
- 一次性现金转移可以部分解决社会经济障碍,但可能无法完全解决这些障碍,以改善结核病诊断和治疗结果.
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