基于社区的结核病接触管理:护理人员的经验和促进坚持预防治疗的因素
Micaela Sandoval1,2, Godwin Mtetwa1,3, Tara Devezin1
1The Global Tuberculosis Program, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States of America.
PLOS global public health
|July 14, 2023
概括
埃斯瓦蒂尼儿童的社区结核病预防疗法 (TPT) 完成率高 (96%). 不遵守的关键预测因素包括低收入,女性性别和城市环境,强调了在TPT交付中需要有针对性的支持.
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
- 全球健康 全球健康
背景情况:
- 结核病预防疗法 (TPT) 对暴露于结核病 (TB) 的儿童至关重要,但在高负担地区面临实施挑战.
- 基于社区的方法对于减少结核病对弱势儿童群体的影响至关重要.
研究的目的:
- 评估儿童遵守社区TPT的预测因素.
- 评估护理人员在家中使用TPT的经验.
- 在资源有限的环境中,为改进TPT实施的战略提供信息.
主要方法:
- 在埃斯瓦提尼,一个以社区为基础的家庭接触管理计划 (Vikela Ekhaya) 选了儿童,启动了TPT,并监测了遵守.
- 多变量聚类考克斯回归模型确定了TPT不遵守的风险因素.
- 半结构面试探讨了护理人员对TPT家庭访问的看法.
主要成果:
- 278名儿童中有96%完成了TPT.
- 不遵守的风险因素包括家庭收入低,女儿性别和城市生活环境.
- 早期的不坚持显著增加了整体治疗不完成的可能性.
结论:
- 基于社区的TPT交付显示出出色的结果,并且被护理人员所偏爱.
- 需要针对特定人群 (低收入人群,城市人群,女性儿童) 提供有针对性的支持,以加强对TPT的遵守.
- 这些发现支持世卫组织对分散结核病预防服务的建议.
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