遗漏的抗结核治疗剂量对治疗结果的影响:一个多中心队列研究
Isabella B B Ferreira1,2, Rodrigo C Menezes2,3,4, Mariana Araújo-Pereira2,3,4
1Escola Bahiana de Medicina e Saúde Pública, Pós-graduação em Medicina e Saúde Humana, Salvador, Brazil.
Lancet regional health. Americas
|July 14, 2025
概括
即使是轻微的不坚持结核病治疗,也会显著增加不良结果的风险. 坚持是成功治疗结核病和预防疾病复发或失败的关键.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 临床医学 临床医学
背景情况:
- 结核病 (TB) 仍然是传染病死亡的主要全球原因.
- 不坚持治疗会影响结核病治疗的成功率,尤其是在现实环境中.
- 直接观察疗法 (DOT) 被广泛使用,但不坚持仍然存在.
研究的目的:
- 评估遗漏剂量对结核病治疗结果的影响.
- 量化非坚持和不良结核病治疗结果之间的关联.
主要方法:
- 对药物敏感结核病成年人的前性队列研究.
- 在五个临床中心进行治疗开始后两年的随访.
- 不坚持被定义为错过剂量的百分比,通过DOT监测;主要结局是治疗失败,复发,耐药性,死亡或对随访的损失的组合.
主要成果:
- 在578名参与者中,37.7%的人有不利的结果.
- 23%的参与者错过了超过10%的剂量,不良结果的可能性为81.2%.
- 遗漏剂量的百分比和不良结果之间发现了显著的关联 (aOR:1.11,p < 0.0001).
结论:
- 即使是轻微的不坚持结核病治疗也与不良结果的风险增加有关.
- 在成功的结核病护理中,坚持发挥着至关重要的作用.
- 改善结核病坚持的策略对于有效的结核病管理至关重要.
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