TUBERCULOSIS CASE-FINDING IN EASTERN NEPAL

TUBERCULOSIS CASE-FINDING IN EASTERN NEPAL
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DOI：
10.1016/s0041-3879(82)80028-7
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发表时间：
1982-01-01
期刊：
TUBERCLE
影响因子：
--
通讯作者：
RAHUT, CB
RAHUT, CB
中科院分区：
其他
文献类型：
--
作者：
CASSELS, A;HEINEMAN, E;RAHUT, CB

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对尼泊尔东部使用的两种病例发现方法进行了比较。结果和病人的依从性方面的差异，在1个区进行了详细的检查，并与其他4个邻近地区的结果进行了比较。比较的两种方法是由移动的团队进行的主动病例发现（ACF）和患者向现有服务的自我转诊（SR）。在一个已建立结核病服务的地区，ACF的一项运动发现了一些没有雅阁接受治疗的病人。这些患者往往比SR患者年龄更大，女性比例更高。ACF患者比SR患者更容易违约[药物]治疗，老年女性比老年男性更容易违约。邻近卫生设施或在卫生站治疗并没有降低ACF组的违约比例;这两个因素对SR患者的违约率有积极影响。超过90%的ACF患者在6个月内出现第一次违约。而且，如果他们返回，他们比SR患者更有可能再次违约。完成1年痰菌转阴治疗的ACF患者数量显著低于本地区和其他3个地区的SR患者。在一个没有单独的结核病服务存在的地区，ACF患者的治愈率显着低于4个地区已建立单独的服务。
Two methods of case-finding used in eastern Nepal were compared. The differences in terms of outcome and patient compliance in 1 district were examined in detail and compared with results in 4 other neighboring districts. The 2 methods compared were active case-finding (ACF) carried out by mobile teams and self referral (SR) of patients to the existing services. In a district with established tuberculosis services, an ACF campaign revealed patients that had not presented for treatment of their own accord. These patients tended to be older than SR patients and there was a higher proportion of women. ACF patients defaulted from [drug] treatment more than SR patients and older women were more likely to default than older men. Proximity to a health facility or treatment at a health post did not decrease the proportion defaulting in the ACF group; both these factors positively influenced the default rate in SR patients. Over 90% of the ACF patients had their 1st period of default within 6 mo. of starting treatment, and, if they returned, they were more likely than SR patients to default again. The number of ACF patients completing 1 yr treatment with sputum conversion was significantly lower than SR patients in this and 3 other districts. In a district where no separate tuberculosis services existed, the cure rate among ACF patients was significantly lower than in 4 districts where separate services had been established.