与直接观察治疗和不成功治疗的转诊相关的因素
Y D González Diaz1, D Palma2, H Vargas-Leguás3
1Serveis Clínics, Barcelona.
概括
直接观察治疗 (DOT) 对易受结核病 (TB) 患者至关重要. 在无家可归,不活跃或吸毒人口中增加DOT的使用可以改善治疗的坚持和结果.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 结核病 (TB) 仍然是一个重大的全球卫生挑战,需要有效的治疗策略.
- 直接观察治疗 (DOT) 是确保治疗遵守的关键干预措施,特别是在高风险人群中.
- 了解影响DOT指示和治疗成功的因素对于优化结核病控制工作至关重要.
研究的目的:
- 为了描述在西班牙适用于DOT的个人.
- 确定与结核病治疗结果不成功相关的因素.
- 为脆弱群体结核病管理的公共卫生战略提供信息.
主要方法:
- 一项多中心观察性研究,涉及西班牙18岁以上的7,883名结核病患者的前性随访 (2006-2019).
- 收集的数据包括来自结核病研究综合计划 (PII-TB) 注册表的社会人口统计和临床变量.
- 统计分析使用调整的几率比率 (aOR) 来确定与DOT指示和治疗失败相关的因素.
主要成果:
- DOT的适应与无家可归,不活动,饮酒,药物使用和艾滋病毒诊断有显著联系.
- 不成功的治疗结果与艾滋病毒诊断,较差的临床/放射性进展,住院治疗,耐受性差,治疗满意度低有关.
- 理解处方治疗的困难也与结核病治疗不成功相关.
结论:
- 弱势群体,包括那些无家可归,不活跃或有物质使用障碍或艾滋病毒的人,是DOT指示的关键群体.
- 在这些风险群体中增加DOT对于改善结核病治疗的坚持,随访和患者整体结果至关重要.
- 这些发现支持在2023-2030年全球结核病终结计划中优先考虑弱势群体.
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