Accuracy of Self-Reported Adherence to Tuberculosis Therapy among DOTS patients in Mumbai

International journal of health research and innovation Pub Date : 2011-10-05 DOI:10.4314/IJHR.V3I3.70277

N. Sathiakumar, S. Bagchi, D. Singh, Pk Vijay, G. Ambe

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引用次数: 1

Abstract

Purpose: To compared self-reported adherence to DOTS therapy with urine rifampicin metabolite levels and medical records among patients in Mumbai, India. Methods: Study subjects (N=538) were randomly selected from the DOTS centers in Mumbai, India. Self-reported adherence was ascertained by interviews; unannounced home visits were conducted, and urine samples were collected for rifampicin metabolite testing using the n-butanol test. Information from medical records was abstracted for documented receipt of drugs from the DOTS centers. Results: Agreement between self-reported adherence and urine tests was very poor (kappa, 0.08); and between self-reports and medical records was moderate (kappa, 0.47). Receipt of drugs did not ensure adherence. Based on urine n-butanol test, 75% of patients were adherent. Physical appearance of urine for rifampicin excretion with the n-butanol extraction method indicated a high positive predictive value (95%). Conclusion: We recommend incorporating urine tests for various drug metabolites periodically in the DOTS program to ensure treatment adherence. Keywords: Tuberculosis; Adherence; Urine testing; Rifampicin; DOTS

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孟买DOTS患者自我报告结核病治疗依从性的准确性

目的:比较印度孟买患者自我报告的DOTS治疗依从性与尿利福平代谢物水平和医疗记录。方法:从印度孟买DOTS中心随机抽取研究对象538例。自我报告的依从性是通过访谈确定的;进行了不事先通知的家访，并收集尿液样本，使用正丁醇试验进行利福平代谢物检测。从医疗记录中提取信息，以记录从DOTS中心收到的药品。结果:自述依从性与尿检之间的一致性非常差(kappa, 0.08);自我报告与医疗记录之间存在中度差异(kappa, 0.47)。收到药物并不能保证依从性。根据尿正丁醇试验，75%的患者粘附。用正丁醇提取法检测尿液的物理外观对利福平排泄具有较高的阳性预测值(95%)。结论:我们建议在DOTS计划中定期纳入尿检各种药物代谢物，以确保治疗依从性。关键词:结核病;依从性;尿液测试;利福平;点

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International journal of health research and innovation

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