转移或从监狱释放后结核病治疗结果:来自巴西的回顾性队列研究
Yasmine Mabene1, José Victor Bortolotto Bampi2, Everton Ferreira Lemos3,4
1Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA, USA.
BMC global and public health
|October 22, 2025
概括
与监禁相关的移动,如转移和释放,扰乱了被剥夺自由 (PDL) 人的结核病 (TB) 治疗. 确保护理的连续性对于成功治疗结核病患者的结核病治疗结果至关重要.
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) 不成比例地影响被剥夺自由的人 (PDL).
- 虽然PDL的结核病治疗完成率往往高于普通人群,但与监禁相关的移动对结局的影响还未得到充分研究.
- 了解这些运动是改善结核病控制在惩戒机构的关键.
研究的目的:
- 调查设施间转移和社区释放对PDL中的结核病治疗结果的影响.
- 量化与监禁相关的移动相关的不利治疗结果的风险.
主要方法:
- 一项队列研究将巴西南部马托格罗索州 (2006-2018) 的监禁和结核病通知数据联系起来.
- 对新诊断的药物敏感结核病的PDL进行了跟踪,以根据运动状态 (停留,转移,释放) 进行治疗结果的比较.
- 计算了对不利结果的相对风险,调整为共变量.
主要成果:
- 在1261名开始结核病治疗的PDL中,66.8%留在设施中,20.3%转移,12.9%释放.
- 治疗成功率为72.9% (停留),61.7% (转移) 和50.3% (释放).
- 转移增加了不良结果的1.4倍,释放的1.6倍 (与那些留下的人相比). 早期释放 (<2个月) 将风险增加了一倍 (aRR: 2.1).
结论:
- 设施间的转移和释放是完成PDL结核病治疗的重大障碍.
- 迫切需要在整个惩戒设施以及惩戒和社区卫生系统之间提供持续的护理.
- 实施减轻因移动造成的干扰的策略对于改善这一群体的结核病结果至关重要.
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