转移或从监狱释放后结核病治疗结果:巴西的一项回顾性队列研究
Yasmine Mabene1, José Bampi2, Everton Ferreira Lemos3,4
1Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
概括
与监禁相关的转移和释放显著增加了结核病 (TB) 治疗不良结果的风险. 确保护理的连续性对于改善结核病治疗在监禁人口中的成功至关重要.
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:
- 结核病 (TB) 不成比例地影响被监禁的人.
- 之前的研究表明,与普通人群相比,在惩戒设施中结核病治疗完成率更高.
- 与监禁相关的移动对结核病治疗结果的影响仍未得到充分研究.
研究的目的:
- 调查监禁相关的移动 (转移,释放) 与结核病治疗结果之间的关联.
- 量化与这些移动相关的不良治疗结果风险.
主要方法:
- 一项连接监禁和结核病通报数据的队列研究在巴西南部马托格罗索州 (2006-2018).
- 包括新诊断出耐药结核病的个人,他们在监禁期间开始接受治疗.
- 与被转移或释放的个人相比,留在同一设施的个人之间的治疗结果的比较,使用对 covariate 调整的相对风险.
主要成果:
- 在监禁期间,有1,274人开始接受结核病治疗.
- 转移 (61.0%) 和释放 (49.4%) 个体的成功治疗率低于留在同一设施 (72.3%) 的患者.
- 与留在同一设施相比,转移增加了1.4倍的不利结果,释放增加了1.6倍.
结论:
- 监禁转移和释放是常见的,并对结核病治疗完成构成重大障碍.
- 监狱和社区卫生系统之间的护理连续性至关重要.
- 迫切需要采取战略,以改善受监禁影响的个人结核病的结果.
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