改善潜伏和活跃结核病治疗完成率的干预措施在低发病率国家的服务不足群体:一个范围审查
Janine Dretzke1, Carla Hobart2, Anamika Basu2
1Institute of Applied Health Research, University of Birmingham, Birmingham, UK j.dretzke@bham.ac.uk.
BMJ open
|March 12, 2024
概括
短时间治疗,视频观察疗法和定制支持等干预措施对改善服务不足群体的结核病 (TB) 治疗坚持有希望. 需要更多的研究来证实这些发现在不同的人群中.
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
- 医疗保健服务研究 医疗服务研究
背景情况:
- 服务不足的人群患结核病 (TB) 发病率较高,治疗结果较差.
- 健康的社会决定因素对结核病管理和患者的结核病坚持有重大影响.
- 针对性干预对于改善脆弱群体的结核病治疗成功至关重要.
研究的目的:
- 进行范围审查,确定旨在提高结核病治疗坚持和完成率的干预措施.
- 在低发病率国家中,综合结合有关结核病管理在服务不足人口中的有效策略的证据.
主要方法:
- 在MEDLINE,Embase和Cochrane CENTRAL的综合文献搜索 (2015年1月至2023年12月).
- 包括任何设计的研究,重点是治疗结核病的干预措施,在服务不足的人群中坚持或完成结核病治疗.
- 叙述报告和对47项已识别的研究结果的表格表.
主要成果:
- 有限的证据表明,较短的治疗方案,视频观察治疗,直接观察治疗以及量身定制的健康/社会支持可能会改善结核病的结果.
- 移民和难民是最受研究的服务不足群体;关于其他人口 (例如吉普赛人,罗姆人,旅行者,心理健康,性工作者) 的数据很少.
- 关键障碍包括缺乏知识和社会支持,而促进者涉及健康教育,值得信赖的患者-提供者关系和社会支持.
结论:
- 目前对缺乏服务的人群结核病干预措施的证据基础有限,只有很少有高质量的受控研究.
- 进一步严格的研究是必要的,以验证发现和指导政策有效的结核病管理.
- 建议进行包括多种服务不足群体在内的定性研究,以丰富理解并为实践提供信息.
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