一项关于儿童结核病预防治疗的开放标签集群随机试验。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI:10.5588/ijtldopen.24.0467
G Lemvik, L Larsson, F Rudolf, J E Vejrum, M Sodemann, V F Gomes, C Wejse
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引用次数: 0

摘要

背景:在对几内亚比绍儿童进行的一项为期9个月的异烟肼预防性治疗(IPT)研究中,76%在家中感染结核病的儿童完成了6个月的IPT治疗。我们的目的是检验与 9 个月的异烟肼(INH)相比,4 个月的利福平和异烟肼(RH)是否能提高坚持治疗的比例:我们对每月服用规定剂量80%(通过药片计数评估)的儿童进行了一项开放标签分组随机优效研究。我们的目标是3个月的RH或6个月的INH:共纳入了来自 223 个家庭的 752 名儿童,其中 INH 组 354 名,RH 组 398 名。总体而言,57%的儿童服用了超过80%的处方药。在 INH 组中,68% 的儿童完成了 6 个月的治疗,而在 RH 组中,61% 的儿童完成了 3 个月(OR 1.32,95% CI 0.90-1.95)。两组未坚持治疗的主要原因都是出差或搬迁,占漏服的50%:结论:缩短 4 个月的 RH 预防性治疗并没有提高几内亚比绍儿童的依从性。旅行是不坚持治疗的主要原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An open-label cluster-randomised trial on TB preventive therapy for children.

Background: In a study on 9 months of isoniazid preventive therapy (IPT) in children in Guinea-Bissau, 76% of children exposed to TB at home completed 6 months of IPT. We aimed to test whether 4 months of rifampicin and isoniazid (RH) would improve adherence compared to 9 months of isoniazid (INH).

Methods: We conducted an open-label cluster-randomised superiority study in children aged <15 years living with a TB case. Children were randomised by house to receive 4 months of RH or 9 months of INH. RH was given as a fixed-combination pill. The primary outcome was adherence, defined as taking >80% of prescribed dosages per month, assessed by pill count. Our aim was 3 months of RH or 6 months of INH.

Results: A total of 752 children from 223 houses were included, 354 in the INH group and 398 in the RH group. Overall, 57% of the children took >80% of the prescribed pills. In the INH group, 68% completed 6 months of therapy, while 61% of the RH group completed 3 months (OR 1.32, 95% CI 0.90-1.95). The main reason for non-adherence in both groups was travel or relocation, accounting for 50% of missed doses.

Conclusion: The shorter preventive therapy of 4 months of RH did not improve adherence in children in Guinea-Bissau. Travelling was the primary reason for non-adherence.

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