Noncompliance to DOTS: How it can be Decreased.
Noncompliance to DOTS: How it can be Decreased.
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DOI：
10.4103/0970-0218.80789
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发表时间：
2011-01-01
期刊：
影响因子：
--
通讯作者：
Gupta, Sc
中科院分区：
文献类型：
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作者：
Mittal, Chhaya;Gupta, Sc
背景技术背景：结核病是一种需要长期治疗的传染病，WHO推荐的治疗方案对预防和治疗结核病都非常有效，但药物依从性差是全球控制结核病的主要障碍。目的：目的是从接受直接观察治疗短程化疗的结核病患者队列中找出治疗失败的原因。本横断面研究在阿格拉市进行，采用多阶段简单随机sampling.MATERIALS AND METHODS：从2007年1月起，共有900名参加DOTS中心选定的指定显微镜中心（DMC）的患者被纳入本研究。资料来源于患者的治疗卡，对未参加治疗的患者进行社区访谈。统计学分析：采用Epi Info软件进行卡方检验，观察两者之间的关联性结果：45岁以上（22.8%）、男性（18.7%）、企业家（30.6%）、退休和失业患者中的违约率较高。与较高默认相关的其他因素为肺部疾病（18.2%）、重新治疗病例（30.6%）和II类患者（26.4%）。缺席的重要原因是药物副作用（43.2%），症状改善（14.4%）和缺乏时间（13.5%）。结论：不依从主要是由于药物的副作用，缺乏时间，和不了解。因此，教育患者了解结核病的各个方面以及减少副作用的一些措施至关重要。
BACKGROUND: Tuberculosis is a communicable disease requiring prolonged treatment.The therapeutic regimens as recommended by WHO have been shown to be highly effective for both preventing and treating tuberculosis but poor adherence to medication is a major barrier to its global control.AIM: The aim was to elicit reasons of treatment default from a cohort of tuberculosis patients treated under Directly Observed Treatment Short course chemotherapy.SETTINGS AND DESIGN: Thiscross-sectional study was conducted in Agra city using the multistage simple random sampling.MATERIALS AND METHODS: A total of 900 patients attending DOTS centres of the selected designated microscopy centers (DMCs) were included in the study from January 2007 onward. The information was obtained from treatment cards of patients and those who defaulted were further interviewed in community.STATISTICAL ANALYSIS: Chi-square test was applied to observe the significance of association using the Epi Info software (version 6).RESULTS: More default was observed among the age group of >45 years (22.8%), male (18.7%), business men (30.6%), and retired and unemployed patients. Other factors associated with higher default were pulmonary disease (18.2%), retreatment cases (30.6%) and category II patients (26.4%). Important reasons of default were side effects following medication (43.2%), improvement in symptoms (14.4%), and lack of time (13.5%). No relief in symptoms and lack of awareness were other important reasons.CONCLUSIONS: Noncompliance was found to be mainly due to side effects of medicines, lack of time, and unawareness. So educating the patient about various aspects of tuberculosis and some measures to decrease side effects are of utmost importance.