为患有多药耐药结核病和艾滋病毒同时感染的人提供差异化的服务提供框架
Karl Reis1, Allison Wolf2, Rubeshan Perumal3
1Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY.
Journal of acquired immune deficiency syndromes (1999)
|February 7, 2024
概括
制定针对多药耐药结核病 (MDR-TB) 和艾滋病毒/艾滋病的差异化服务提供 (DSD) 框架至关重要. 这项研究确定了坚持模式和障碍,以告知新的MDR-TB/HIV DSD模型,以改善患者的治疗结果.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 差异化服务交付 (DSD) 模式是HIV/AIDS护理的标准.
- 患有多抗药结核病 (MDR-TB) 和艾滋病毒/艾滋病的患者面临重大治疗挑战.
- 目前没有一个DSD模型专门解决了MDR-TB和HIV/AIDS患者的复杂需求.
研究的目的:
- 在MDR-TB和HIV/AIDS患者中定义药物坚持模式.
- 描述影响治疗坚持性的纵向障碍.
- 为开发针对MDR-TB/HIV联合感染的量身定制的DSD框架提供信息.
主要方法:
- 在南非的克瓦祖鲁-纳塔尔州招募了患有MDR-TB和HIV的成年人,他们开始使用贝达基林 (BDQ) 和抗逆转录病毒疗法 (ART).
- 电子剂量监测设备 (EDM) 用于跟踪BDQ和ART的遵守.
- 进行了纵向焦点小组,以确定不同阶段的治疗挑战.
主要成果:
- 283名参与者通过MDR-TB治疗完成 (中位数为17.8个月) 进行了跟踪.
- 大多数参与者 (82.7%) 保持了高度的坚持 (BDQ: 95.3%,ART: 85.5%).
- 一个子群体 (17.3%) 显示了坚持挑战,在6个月内每周BDQ和ART坚持显著下降,与心理社会,行为和结构障碍有关.
结论:
- 对MDR-TB/HIV的DSD框架必须为坚持挑战的个人提供加强的支持.
- 在整个治疗过程中,需要多模式的坚持支持.
- 该框架应解决不同治疗阶段特有的心理,行为和结构障碍.
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