Predictors of adherence to tuberculosis treatment in a supervised therapy programme for prisoners before and after release
Predictors of adherence to tuberculosis treatment in a supervised therapy programme for prisoners before and after release
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DOI：
10.1183/09031936.98.12040967
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发表时间：
1998-10-01
影响因子：
24.3
通讯作者：
Ribot, N
中科院分区：
文献类型：
--
作者：
Marco, A;Cayla, JA;Ribot, N
监狱人口是结核病(TB)的高危人群，这项调查旨在研究参与监督治疗试点方案的囚犯中遵守治疗的预测因素。研究对象包括1995年在巴塞罗那男子监狱中心(MPCB)、在医务室或在美沙酮方案中进行直接监督治疗(DOT)的结核病患者。获释囚犯仅指市政维持美沙酮方案和其他社会资源。仅用于改善遵从性的奖励和促进因素(为营养和住房需求提供经济援助、美沙酮方案和进入社会卫生中心)，患者遵守的结果分类如下：完成、违约、死亡或转出。通过Logistic回归分析与依从性相关的因素，包括62名患者，其中43人为静脉吸毒者，46人感染人类免疫缺陷病毒(HIV)。19人以前患过结核病，32人在治疗结核病期间刚刚出狱。总体依从性为89%；在监狱内完成治疗的人中，97%；在监狱外完成治疗的人中，79%(p=0.05)，95%的静注DU患者完成了治疗。无家可归或酗酒的流放犯只有在进入社会隔离中心才能完成治疗，在整个治疗过程中DOT导致更好的依从性(优势比(OR)=16.80；可信区间(CI)：2.42-116.2)。那些在整个治疗过程中被监禁的人也表现出更好的依从性(OR=7.36；CI：0.79-48.16)，即使在释放后，监狱内和监狱外方案之间充分协调，囚犯的抗结核病治疗依从性也很高。事实证明，维持美沙酮方案对静脉注射吸毒者非常有用，进入社会卫生中心接受治疗的贫困或酗酒的流放犯也是如此。(C)ERS Journal Ltd 1998。
The prison population is a high-risk group for tuberculosis (TB), This investigation aimed to study predictive factors of treatment adherence among prisoners involved in a pilot programme of supervised treatment.The study included TB patients from the Men's Penitentiary Center of Barcelona (MPCB) in 1995, Directly observed therapy (DOT) was carried out in the infirmary or in a methadone programme. Released prisoners mere referred to the municipal maintenance methadone programmes (MMP) and other social resources. Incentives and enablers mere used to improve compliance (economic aid for nutritional and housing needs, methadone programmes and admittance to a sociosanitary centre), The outcome of the patients' adherence was classified as follows: completed, defaulted, dead or transferred out. Factors associated with adherence were investigated through logistic regression.The programme included 62 patients, 43 of whom were intravenous drug users (IVDU) and 46 were infected with the human immunodeficiency virus (HIV). Nineteen had previously had TB and 32 mere released from prison during TB treatment. Overall adherence was 89%; 97% among those who completed treatment in prison, and 79% among those who completed treatment outside prison (p=0.05), Ninety-five per cent of IVDU in an MMP completed treatment. Homeless or alcoholic exprisoners completed treatment only if they were admitted to sociosanitary centres, DOT throughout treatment resulted in better adherence (odds ratio (OR)= 16.80; confidence interval (CI): 2.42-116.2). Those who were incarcerated throughout treatment also showed better adherence (OR= 7.36; CI: 0.79-48.16),Antituberculosis treatment adherence in prisoners was high even after release with adequate co-ordination among intrapenitentiary and extrapenitentiary programmes. Maintenance methadone programmes proved very useful in intravenous drug users, as did admittance to sociosanitary centres for indigent or alcoholic exprisoners undergoing treatment. (C) ERS Journals Ltd 1998.