通过加纳的私人提供者扩大结核病例的发现:使用中断时间序列进行影响评估
Kenneth Mawuta Hayibor1,2, Ernest Kenu3, Gloria Ivy Mensah2
1Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany.
Frontiers in public health
|September 11, 2025
概括
加纳的一种公私混合 (PPM) 直接观察疗法 (DOT) 模型在城市地区显著增加了结核病 (TB) 病例的检测. 这一策略涉及私人提供者和保险计划,推用于国家结核病计划,以改善监测和控制.
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
- 卫生系统研究 卫生系统研究
背景情况:
- 尽管在加纳提供免费服务,但结核病 (TB) 病例的发现率很低,主要发生在公共设施中.
- 实施了公私混合 (PPM) 直接观察治疗 (DOT) 模型,以加强结核病例的发现.
- 这个模式整合了社区私人医疗保健提供者和国家健康保险计划 (NHIS).
研究的目的:
- 评估PPM DOT模型对加纳结核病例检测的影响.
- 评估针对弱势城市人口的干预措施的有效性.
- 分析干预前后结核病例报告的趋势.
主要方法:
- 使用比较中断时间序列 (ITS) 分析进行影响评估.
- 从查,结核病登记册和国家结核病例通知 (2015-2022) 中收集的数据.
- 在加纳最大的两个大都市地区实施的干预措施 (2018年第四季度 - 2020年第一季度).
主要成果:
- 超过563,000人进行了查,确定了590例结核病例 (95.3%的细菌学证实).
- 在干预区域,结核病例的通知增加 (2018年为1392例,2019年为1462例).
- ITS分析显示,与控制区域相比,干预区域的结核病例报告率呈显著的积极趋势.
结论:
- 通过PPM DOT模型扩大免费的结核病服务,提高了城市环境中的结核病例检测.
- 持续的社区参与对于成功控制结核病至关重要.
- 国家结核病计划应该考虑扩大这种方法,以改善结核病监测和控制工作.
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