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引用次数: 0
摘要
背景:圣多美和普林西比(STP)是几内亚湾的一个中低收入国家，接受治疗的结核病患者持续大量流失。目的:调查与患者失访(LTFU)相关的因素，并评估卫生工作者对不依从性的看法。设计:使用国家数据库的数据进行回顾性队列研究。使用单变量和多变量logistic回归研究与LTFU相关的因素。与结核病卫生工作者进行了深入访谈，以确定完成治疗的感知障碍。结果:共纳入822例登记的药敏结核患者，其中失访82例(10.0%)。男性(调整OR [aOR] 1.7, 95% CI 1.0-3.0;P = 0.048)，以及居住在Mé-Zóchi和cau地区(aOR 2.60, 95% CI 1.58-4.26;P < 0.001)与LTFU发生率增加相关。完成治疗的主要障碍与缺乏食物、耻辱感、缺乏患者信息和个人支持有关。结论:该研究表明，在结核病治疗过程中需要解决与LTFU相关的多个问题。加强个性化护理的努力，特别是在信息、营养和鼓励方面，将更好地支持STP患者。
TB treatment non-adherence in São Tomé and Príncipe.
Setting: Sao Tomé and Principe (STP) is a lower middle-income country in the Gulf of Guinea that has a persistent high loss of TB patients on treatment.
Objective: To investigate factors associated with patient loss to follow-up (LTFU) and to assess health worker perceptions on non-adherence.
Design: A retrospective cohort study was conducted using data from the national database. Factors associated with LTFU were investigated using univariable and multivariable logistic regression. In-depth interviews were conducted with TB health workers to identify perceived barriers for treatment completion.
Results: A total of 822 registered patients with drug-susceptible TB were included, of whom 82 (10.0%) were lost to follow-up. Male sex (adjusted OR [aOR] 1.7, 95% CI 1.0-3.0; P = 0.048), as well as living in the Mé-Zóchi and Caué Districts (aOR 2.60, 95% CI 1.58-4.26; P < 0.001) were associated with an increased odds of LTFU. The main barriers to treatment completion were related to lack of food, stigma, and lack of patient information and personal support.
Conclusion: The study indicates the need to address multiple issues related to LTFU during TB treatment. Enhanced efforts to personalise care, especially for information, nutrition and encouragement will better support patients in STP.
期刊介绍：
Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
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