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整合基于胸部X射线的结核病查和巴基斯坦家庭接触者的预防性治疗:试点研究
Nida Khan1, Muhammad Ahmar Khan2, Ahmad Ismail3
1Association for Social Development, Islamabad, Pakistan. nidakhan@asd.com.pk.
BMC infectious diseases
|December 23, 2025
概括
将胸部X射线 (CXR) 查和结核病预防治疗 (TPT) 整合到初级卫生保健中是可行的. 数字监控支持这种干预,用于结核病患者的家庭接触者 (HHC).
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:
- 巴基斯坦面临着高结核病 (TB) 发病率,治疗率低于最佳.
- 世界卫生组织 (WHO) 的指导方针建议为家庭接触者 (HHC) 寻找活跃病例和进行结核病预防治疗 (TPT).
- 一项试点研究整合了世卫组织推的胸部X射线 (CXR) 查和HHCs的TPT,利用PREVENT-TB应用程序收集数据.
研究的目的:
- 评估基于CXR的结核病查在HCs中的可接受性和可行性.
- 评估符合条件的HHC中TPT的启动和完成率.
- 确定使用移动应用程序进行干预文档和监测的可行性.
主要方法:
- 在巴基斯坦旁遮普省的19个医疗保健机构进行的一项混合方法试点研究 (2021年12月至2023年9月).
- 涉及CXR和HCs的症状查,TPT启动和通过PREVENT-TB应用程序收集数据.
- 使用描述性统计和物流回归分析的定量数据;用主题分析的定性数据.
主要成果:
- 在2817个确定的HHC中,有1421个 (50%) 接受了查;118个 (8%) 有症状或CXR异常,导致5个新的结核病诊断.
- 68% (957/1416) 符合条件的HHC开始TPT,其中94% (903/957) 完成了治疗.
- 被认为缺乏需求是查/拒绝TPT的主要原因;数字数据收集证明了实施和监控的有效性.
结论:
- 将CXR查和TPT整合到常规的初级卫生保健中是可行的.
- 数字监控有效支持结核病例发现和预防治疗干预措施的实施和监督.
- 该试点展示了一个可行的模型,用于改善高发病率环境中的高发病率患者的结核病控制.
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