一个以用户为中心的实施战略结核接触调查在乌干达:一个阶段,集群随机试验的协议
Achilles Katamba1,2, Amanda J Gupta1,3,4, Patricia Turimumahoro1
1Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda.
BMC public health
|August 17, 2023
概括
本研究评估了一项以用户为中心的战略,以改善乌干达结核病 (TB) 接触调查. 目标是增加在密切接触者中及时诊断和治疗结核病.
科学领域:
- 公共卫生 公共卫生
- 实施科学 实施科学
- 传染病流行病学 传染病流行病学
背景情况:
- 结核病 (TB) 仍然是全球主要的传染性死亡原因.
- 接触调查是世卫组织认可的结核病诊断,治疗和预防战略,但实施仍然是一个挑战.
- 有效的实施策略对于控制结核病传播至关重要.
研究的目的:
- 将以用户为中心的战略与在乌干达医疗保健机构实施结核病接触调查的标准策略进行比较.
- 评估以用户为中心的方法在改善结核病例发现和接触者之间的治疗启动方面的有效性.
- 评估以人为中心的设计和实践社区对于在低资源环境中维持结核病干预措施的适用性.
主要方法:
- 在12个乌干达医疗保健机构进行了分阶,集群随机化,混合型III实施有效性试验.
- 以用户为中心的策略 (包括教育材料,算法,视频,运输支持,协作会议,审计反和数字聊天) 与标准策略的比较.
- 测量结果包括症状接触者在60天内完成结核病评估,诊断和开始结核病治疗或预防治疗的比例.
主要成果:
- 主要实施结果:在60天内完成结核病评估的有症状的亲密接触者的比例.
- 主要临床疗效结果:接触者中被诊断出活跃结核病并开始治疗的比例,以及在60天内开始结核病预防治疗的比例.
- 嵌套混合方法研究将评估实施忠实性,上下文,成本效益和影响.
结论:
- 这项务实的试验将为优化结核病接触调查在高负担环境中提供关键数据.
- 结果将为发现和预防未被诊断的结核病病例的策略提供信息.
- 该研究将评估以人为中心的设计和实践社区在实施和维持低收入和中等收入国家基于证据的干预措施中的作用.
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