结核病患者家庭接触者的结核病预防治疗——西孟加拉邦穆尔西达巴德区一个街区的覆盖率和相关因素：一项横断面研究

Q3 Medicine

Indian Journal of Tuberculosis Pub Date : 2025-07-01 DOI:10.1016/j.ijtb.2024.06.002

Ophelia Mukherjee, Dilip Kumar Das, Mrinmoy Adhikary, Ritu Ghosh

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引用次数: 0

摘要

背景：印度开始在所有家庭结核病接触者中实施结核病预防治疗，这是一项全球公认的消除结核病战略。我们旨在评估TPT的覆盖范围和依从性；确定不开始和不遵守的原因；并确定覆盖率的相关性。方法我们于2023年9 - 11月在西孟加拉邦穆尔西达巴德地区的一个街区进行了一项横断面研究。研究了在2002年10月22日至2003年3月期间登记的301例符合条件的“指示病例”（微生物学证实的药物敏感性肺结核）家庭接触者的计算样本。我们按照预先设计的时间表和事先知情同意对参与者/受访者进行访谈。描述性和推断性统计通过社会科学统计软件包（第20版）应用。结果301名接触者中，179名（59.5%）在家庭中进行单独追踪/咨询；238人（79.1%）接受了结核病症状筛查。TPT启动率为74.8%(225/301)，其中47.1%在指标病例7天内启动治疗；没有卫生人员提供TPT（59.2%）是不开始的主要原因。课程完成率为69.3% (156/225)；认为缺乏需要（50.7%）和迁移（21.7%）是不遵守规定的主要原因。在所有符合条件的接触者中，全课程TPT的总体覆盖率仅为51.8%（156/301）。关于多变量逻辑回归；男性(aOR = 1.982；95% CI = 1.004-3.915)，接触个体追踪/咨询(aOR = 13.507；95% CI = 6.781-26.906)，并进行了症状筛查(aOR = 5.694；95% CI = 2.223-14.587)预测TPT覆盖率显著提高。结论该地区TPT的级联护理指标仍不理想，需要进一步加强其实施的规划方面。

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Tuberculosis preventive treatment among the household contacts of tuberculosis patients – Coverage and correlates in a block of Murshidabad district, West Bengal: A cross-sectional study

Background

India started implementing tuberculosis preventive treatment (TPT) among all household contacts of Tuberculosis (TB) cases, as a globally accepted strategy for elimination of TB.

Objectives

We aimed to assess the extent of TPT coverage and adherence; ascertain the reasons for non-initiation and non-adherence; and to determine the correlates of coverage.

Methods

We conducted a cross-sectional study in a block of Murshidabad district, West Bengal during September–November’2023. A calculated sample of 301 eligible household contacts of ‘index cases’ (microbiologically-confirmed drug-sensitive pulmonary TB) registered during October’22 to March’23 were studied. We interviewed the participants/respondents with pre-designed schedule and prior informed consent. Descriptive and inferential statistics were applied through Statistical Package for Social Sciences (version 20).

Results

Of 301 contacts, 179(59.5%) individually traced/counseled at the household; 238 (79.1%) were screened for TB symptoms. TPT initiation was 74.8% (225/301) with 47.1% within seven days of treatment initiation of index case; TPT not offered by health personnel (59.2%) being major reason for non-initiation. Completion rate with adherence to full course was 69.3% (156/225); perceived lack of need (50.7%) and migration (21.7%) being major reasons for non-adherence. Overall coverage of full course TPT among total eligible contacts was only 51.8% (156/301). On multivariable logistic regression; male gender (aOR = 1.982; 95% CI = 1.004–3.915), contacts with individual tracing/counseling (aOR = 13.507; 95% CI = 6.781–26.906) and who had symptoms screening (aOR = 5.694; 95% CI = 2.223–14.587) predicted significantly higher TPT coverage.

Conclusion

Cascade of care indicators for TPT remains suboptimal in the area and indicates need for further strengthening of programmatic aspects of its implementation.

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来源期刊

Indian Journal of Tuberculosis Medicine-Infectious Diseases

CiteScore

2.80

自引率

0.00%

发文量

103

期刊介绍： Indian Journal of Tuberculosis (IJTB) is an international peer-reviewed journal devoted to the specialty of tuberculosis and lung diseases and is published quarterly. IJTB publishes research on clinical, epidemiological, public health and social aspects of tuberculosis. The journal accepts original research articles, viewpoints, review articles, success stories, interesting case series and case reports on patients suffering from pulmonary, extra-pulmonary tuberculosis as well as other respiratory diseases, Radiology Forum, Short Communications, Book Reviews, abstracts, letters to the editor, editorials on topics of current interest etc. The articles published in IJTB are a key source of information on research in tuberculosis. The journal is indexed in Medline