Factors associated with tuberculosis treatment default in an endemic area of the Brazilian Amazon: a case control-study.
Factors associated with tuberculosis treatment default in an endemic area of the Brazilian Amazon: a case control-study.
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DOI：
10.1371/journal.pone.0039134
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Bührer-Sékula S
中科院分区：
文献类型：
--
作者：
Garrido Mda S;Penna ML;Perez-Porcuna TM;de Souza AB;Marreiro Lda S;Albuquerque BC;Martínez-Espinosa FE;Bührer-Sékula S
治疗违约是结核病控制中的一个严重问题，因为它意味着感染源的持续存在、死亡率增加、复发率增加并促进耐药菌株的产生。这项研究分析了亚马逊州结核病治疗默认的决定因素，以帮助规划适当的控制干预措施。使用 2005 年至 2010 年巴西疾病通报系统数据进行回顾性队列观察研究。采用巢式病例对照研究设计。未接受治疗的患者被视为“病例”，完成治疗的患者被视为“对照”。分析中包括 11,312 名结核病患者、1,584 名病例和 9,728 名对照者。据观察，治疗违约与既往违约（aOR 3.20；p<0.001）、HIV 阳性（aOR 1.62；p<0.001）、酗酒（aOR 1.51；p<0.001）、教育水平低（aOR 1.35；p<0.001）和其他合并症（aOR 1.31；p<0.001）相关。 p = 0.05）。老年患者（aOR 0.98；p = 0.001）和 DOT（aOR 0.72；p<0.01）被认为是违约的保护因素。在解决结核病控制的护理和政策行动时应考虑相关因素。应加强有关疾病和治疗的信息，并与人口的教育水平相适应，以促进坚持治疗并遏制抗结核药物多药耐药性的蔓延。
Treatment default is a serious problem in tuberculosis control because it implies persistence of infection source, increased mortality, increased relapse rates and facilitates the development of resistant strains. This study analyzed tuberculosis treatment default determinants in the Amazonas State to contribute in planning appropriate control interventions. Observational study with a retrospective cohort using Brazilian Disease Notification System data from 2005 to 2010. A nested case control study design was used. Patients defaulting from treatment were considered as ‘cases’ and those completing treatment as ‘controls’. In the analysis, 11,312 tuberculosis patients were included, 1,584 cases and 9,728 controls. Treatment default was observed to be associated to previous default (aOR 3.20; p<0.001), HIV positivity (aOR 1.62; p<0.001), alcoholism (aOR 1.51; p<0.001), low education level (aOR 1.35; p<0.001) and other co-morbidities (aOR 1.31; p = 0.05). Older patients (aOR 0.98; p = 0.001) and DOT (aOR 0,72; p<0.01) were considered as protective factor for default. Associated factors should be considered in addressing care and policy actions to tuberculosis control. Information on disease and treatment should be intensified and appropriate to the level of education of the population, in order to promote adherence to treatment and counter the spread of multidrug resistance to anti-TB drugs.
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影响因子：
15.8
作者：
Shargie, Estifanos Biru;Lindtjorn, Bernt
通讯作者：
Lindtjorn, Bernt
影响因子：
4.5
作者：
Ayisi, John G.;van't Hoog, Anna H.;Marston, Barbara J.
通讯作者：
Marston, Barbara J.
DOI：
10.4103/0970-0218.80789
发表时间：
2011-01-01
期刊：
Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine
影响因子：
--
作者：
Mittal, Chhaya;Gupta, Sc
通讯作者：
Gupta, Sc
影响因子：
11.8
作者：
Penna, Gerson;Pinto, Luiz Felipe;Glatt, Ruth
通讯作者：
Glatt, Ruth
影响因子：
3.2
作者：
Mesfin, Mengiste M.;Newell, James N.;Madeley, Richard J.
通讯作者：
Madeley, Richard J.