Predictors of tuberculosis (TB) and antiretroviral (ARV) medication non-adherence in public primary care patients in South Africa: a cross sectional study.
Predictors of tuberculosis (TB) and antiretroviral (ARV) medication non-adherence in public primary care patients in South Africa: a cross sectional study.
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南非公共初级保健患者结核病 (TB) 和抗逆转录病毒 (ARV) 药物治疗不依从的预测因素：一项横断面研究。
DOI：
10.1186/1471-2458-13-396
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发表时间：
2013-04-26
影响因子：
4.5
通讯作者：
Tutshana B
中科院分区：
文献类型：
--
作者：
Naidoo P;Peltzer K;Louw J;Matseke G;McHunu G;Tutshana B
尽管自 2006 年以来结核病 (TB) 病例绝对数量呈下降趋势，且发病率自 2001 年以来也有所下降，但结核病造成的疾病负担仍然是全球健康挑战。结核病和艾滋病毒的共同感染加重了这种疾病负担。通过采取严格的抗结核药物治疗方案，结核病是可以完全治愈的，这需要极高且一致的依从性。本研究的目的是调查与抗结核和艾滋病毒治疗药物依从性相关的因素。采用横断面调查方法。根据每个诊所的最高结核病病例数选择了三个研究区（每个区 14 个初级卫生保健机构）。所有新发结核病和新发结核病复治患者均在抗结核治疗1个月内连续筛查。该样本由 3107 名接受治疗至少三周的结核病患者组成，总样本中的一个子样本同时接受抗结核治疗和抗逆转录病毒治疗 (ART) (N = 757)。数据收集工具包括：社会人口调查问卷；创伤后应激障碍 (PTSD) 筛查；心理困扰量表；酒精使用障碍识别测试（AUDIT）；自我报告烟草使用情况、健康状况感知以及抗结核药物和抗逆转录病毒疗法的依从性。大多数参与者 (N = 3107) 是新发结核病病例，在 18 岁及以上的成年男性和女性样本中，艾滋病毒合并感染率为 55.9%。抗结核药物和双重治疗（ART 和抗结核药物）常见的不依从性的重要预测因素包括贫困、患有一种或多种共存疾病、滥用酒精的高风险以及艾滋病毒呈阳性的伴侣。不坚持抗结核药物的另一个预测因素是吸烟。为结核病患者（无论是否患有艾滋病毒）提供综合治疗计划，以解决贫困、酗酒、烟草使用和心理社会咨询问题。治疗护理方案不仅需要卫生部门的参与，还需要其他相关政府部门的参与，例如社会发展部门。
Despite the downward trend in the absolute number of tuberculosis (TB) cases since 2006 and the fall in the incidence rates since 2001, the burden of disease caused by TB remains a global health challenge. The co-infection between TB and HIV adds to this disease burden. TB is completely curable through the intake of a strict anti-TB drug treatment regimen which requires an extremely high and consistent level of adherence.The aim of this study was to investigate factors associated with adherence to anti-TB and HIV treatment drugs. A cross-sectional survey method was used. Three study districts (14 primary health care facilities in each) were selected on the basis of the highest TB caseload per clinic. All new TB and new TB retreatment patients were consecutively screened within one month of anti-tuberculosis treatment. The sample comprised of 3107 TB patients who had been on treatment for at least three weeks and a sub-sample of the total sample were on both anti-TB treatment and anti-retro-viral therapy(ART) (N = 757). Data collection tools included: a Socio-Demographic Questionnaire; a Post-Traumatic-Stress-Disorder (PTSD) Screen; a Psychological Distress Scale; the Alcohol Use Disorder Identification Test (AUDIT); and self-report measures of tobacco use, perceived health status and adherence to anti-TB drugs and ART. The majority of the participants (N = 3107) were new TB cases with a 55.9% HIV co-infection rate in this adult male and female sample 18 years and older. Significant predictors of non-adherence common to both anti-TB drugs and to dual therapy (ART and anti-TB drugs) included poverty, having one or more co-morbid health condition, being a high risk for alcohol mis-use and a partner who is HIV positive. An additional predictor for non-adherence to anti-TB drugs was tobacco use. A comprehensive treatment programme addressing poverty, alcohol mis-use, tobacco use and psycho-social counseling is indicated for TB patients (with and without HIV). The treatment care package needs to involve not only the health sector but other relevant government sectors, such as social development.
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影响因子：
4.5
作者：
Mindachew, Mesele;Deribew, Amare;Biadgilign, Sibhatu
通讯作者：
Biadgilign, Sibhatu
影响因子：
--
作者：
Kessler, RC;Barker, PR;Zaslavsky, AM
通讯作者：
Zaslavsky, AM
DOI：
10.1080/09540120902729932
发表时间：
2009-01-01
影响因子：
1.7
作者：
Corless, Inge B.;Wantland, Dean;Davis, Sheila M.
通讯作者：
Davis, Sheila M.
影响因子：
1.7
作者：
Li L;Lee SJ;Thammawijaya P;Jiraphongsa C;Rotheram-Borus MJ
通讯作者：
Rotheram-Borus MJ
DOI：
10.1080/09540120802032627
发表时间：
2009-01-01
影响因子：
1.7
作者：
Kalichman, Seth C.;Simbayi, Leickness C.;Ginindza, Themba
通讯作者：
Ginindza, Themba