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一个对儿童结核病预防治疗的开放标签集群随机试验
IJTLD open
|March 17, 2025
概括
与9个月的异化 (INH) 相比,使用利芬素和异化 (RH) 治疗4个月的短时间结核病预防疗法并没有改善儿童的坚持治疗. 在这两组中,旅行是错过剂量的主要原因.
科学领域:
- 儿童传染病 儿童传染病
- 公共卫生干预措施 公共卫生干预措施
- 对结核病进行控制.
背景情况:
- 之前的研究表明,在暴露于结核病的儿童中,对9个月的异化预防疗法 (IPT) 的坚持不佳.
- 在几内亚比绍的儿童中,六个月IPT的坚持率为76%.
研究的目的:
- 在暴露于结核病的儿童中,比较4个月的里法皮辛和异化 (RH) 治疗和9个月的异化 (INH) 治疗之间的坚持率.
- 为了确定较短的RH疗程是否改善了儿科结核病接触管理中的治疗完成.
主要方法:
- 一项开放标签,集群随机优势研究在15岁以下的儿童中进行,这些儿童生活在结核病病例中.
- 参与者按家庭随机分配,接受4个月的RH (固定组合药片) 或9个月的INH.
- 坚持被定义为每月服用>80%的处方剂量,通过药片数量进行评估.
主要成果:
- 总共有752名儿童被纳入; 57%的人坚持治疗 (>80%服用药片).
- 在INH治疗6个月期间,坚持率为68%,而在RH治疗3个月期间为61% (OR1.32,95% CI 0.90-1.95).
- 在这两组中,不服药的主要原因是旅行或搬迁,占遗漏剂量的50%.
结论:
- 与9个月的INH相比,四个月的RH预防疗法没有改善几内亚比绍儿童的坚持.
- 旅行和搬迁被确定为儿童结核病预防治疗遵守的主要障碍.
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