内城医院产前门诊对潜伏性结核感染诊断和治疗的级联护理

IF 1.9 Q3 INFECTIOUS DISEASES
Jay Phansalkar , Rajas Karajgikar , Jai Patel , Shauna Williams , Lisa Gittens-Williams , Alfred A. Lardizabal
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引用次数: 0

摘要

治疗潜伏性结核感染(LTBI)是减轻结核病负担的核心干预措施。LTBI的治疗是具有挑战性的,因为在这个过程中有许多步骤,统称为级联护理。在LTBI的怀孕患者中,由于怀孕带来的医疗和社会复杂性,这些挑战更加突出。在这项研究中,我们评估了筛查干预LTBI在美国市中心医院产前诊所的有效性,并分析了护理级联,以确定需要改进的领域。在量化铁金试验(QFN)阳性的n = 99名患者中,96.7%的患者接受了医生的胸部x光检查,95.6%完成了x光检查,82.8%被转介到结核病诊所,44.4%预约了结核病诊所,23.2%参加了结核病诊所的预约,21.2%开始接受LTBI治疗,17.2%完成了LTBI治疗。这些数据表明,大多数QFN阳性的产前门诊患者没有完成LTBI治疗。大多数患者在从产科护理转向结核病诊所护理的过程中失去了生命。改善LTBI的护理级联将需要加强对患者的教育,使其了解治疗LTBI的重要性,并改进将患者从产科护理过渡到结核病诊所护理的过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cascade of care for the diagnosis and treatment of latent tuberculosis infection in an inner-city hospital prenatal clinic
Treating latent tuberculosis infection (LTBI) is a core intervention in reducing the burden of tuberculosis. Treatment for LTBI is challenging due to the many steps in the process, collectively termed the cascade of care. In pregnant patients with LTBI, these challenges are heightened due to the medical and social intricacies introduced by pregnancy. In this study, we evaluate the effectiveness of a screening intervention for LTBI in the prenatal clinic of an inner-city hospital in the United States, and analyze the cascade of care to identify areas for improvement. Of the n = 99 patients who had a positive QuantiFERON Gold Test (QFN), 96.7 % had a chest x-ray (CXR) ordered by their provider, 95.6 % completed the CXR, 82.8 % were referred to the TB clinic, 44.4 % scheduled an appointment with the TB clinic, 23.2 % attended an appointment at the TB clinic, 21.2 % started medical treatment of LTBI, and 17.2 % completed LTBI treatment. Together this data shows that majority of patients in the prenatal clinic with a positive QFN do not complete LTBI treatment. Most patients are lost during the steps that transition them from obstetric care to the care of the TB clinic. Improving the cascade of care for LTBI will require increased education of patients on the importance of treating LTBI, and improving the process that transitions patients from obstetric care to the care of the TB clinic.
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来源期刊
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.00
自引率
5.00%
发文量
44
审稿时长
30 weeks
期刊介绍: Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.
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