在监狱囚犯中积极查肺结核:来自印度南部普杜切里的一项混合方法研究
Gaurang Narayan1,2, Kavita Vasudevan3, Anandaraj Rajagopal3
1Department of Medical Law and Ethics, National Law School of India University, Bengaluru, IND.
Cureus
|July 3, 2023
概括
监狱囚犯对结核病 (TB) 的积极查对于早期检测至关重要. 这项研究没有发现活跃的结核病例,但发现了高比例的假定结核病症状和糖尿病,突出了这一群体需要定期进行健康教育的必要性.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 健康差异 在健康上的差异
背景情况:
- 可持续发展目标3的目标是到2030年消除结核病,需要在脆弱人群中找到活跃病例 (ACF).
- 监狱囚犯是ACF的关键目标群体,因为他们获得医疗保健的机会有限.
- 肺结核 (PTB) 在印度普遍存在,因此被动病例发现不足.
研究的目的:
- 在监狱囚犯中进行一项混合方法研究,评估PTB和糖尿病 (DM).
- 评估在监狱环境中发现活跃病例 (ACF) 的有效性.
- 探索监狱囚犯与PTB相关的看法和耻辱.
主要方法:
- 一种混合方法的方法,结合了横截面的定量研究和定性聚焦小组讨论 (FGDs).
- 查PTB和DM,包括人体测量和基于盒子的核酸放大测试 (CB-NAAT) 假定结核病例.
- 针对FGD进行有目的抽样,然后进行主题手册内容分析以确定代码和主题.
主要成果:
- 在187名被查的囚犯中,有10.7%的人有症状;然而,没有人通过CB-NAAT检测出PTB阳性.
- 假定结核病例与年龄较大,文盲和并发性疾病有关 (p≤0.05).
- 19.7%的人随机血糖升高 (>140 mg/dL),5.34%的人符合诊断标准 (>200 mg/dL),2.67%的人被新诊断为DM.
结论:
- 积极病例发现 (ACF) 对于早期检测和治疗结核病和DM等疾病在惩戒设施中至关重要.
- 定性调查结果揭示了囚犯中围绕PTB的负面意识形态和耻辱.
- 对于社会边缘化社区,包括监狱囚犯,建议定期进行健康教育,以解决误解并改善健康结果.
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