Treatment interruption and directly observed treatment of multidrug-resistant tuberculosis patients in China

被引:19
作者
Wei, X-L. [1 ]
Yin, J. [1 ]
Zou, G-Y. [2 ]
Zhang, Z-T. [2 ]
Walley, J. [3 ]
Harwell, J. [1 ]
Li, H-T. [4 ]
Sun, Q. [5 ]
Li, R-Z. [6 ]
Wang, L-X. [6 ]
Zhang, X-L. [4 ]
机构
[1] Chinese Univ Hong Kong, Jockey Club Sch Publ Hlth & Primary Care, Hong Kong, Hong Kong, Peoples R China
[2] Univ Leeds China Off, Nuffield Ctr Int Hlth & Dev, Shenzhen, Peoples R China
[3] Univ Leeds, Nuffield Ctr Int Hlth & Dev, Leeds, W Yorkshire, England
[4] Shandong Prov Chest Hosp, Ctr TB Control, Jinan 250101, Shandong, Peoples R China
[5] Shandong Univ, Ctr Hlth Management & Policy, Jinan 250100, Peoples R China
[6] China Ctr Dis Control, Natl Ctr TB Control & Prevent, Beijing, Peoples R China
关键词
MDR-TB; treatment interruption; DOT; community management; family members; RANDOMIZED CONTROLLED-TRIAL; TREATMENT OUTCOMES; SOUTH-AFRICA; ADHERENCE; PREVALENCE; PROVINCE; PROGRAM; DOTS; CARE; TB;
D O I
10.5588/ijtld.14.0485
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
BACKGROUND: China has nearly one fifth of global multidrug-resistant tuberculosis (MDR-TB) cases, and follows the 24-month World Health Organization (WHO) standardised regimens. OBJECTIVE: To assess treatment interruption among MDR-TB patients and its association with the provision of directly observed treatment (DOT). METHODS: We reviewed clinical charts and conducted a questionnaire survey among all confirmed MDR-TB patients who had been treated for at least 6 months from 1 January 2009 to 30 April 2012 in Shandong Province. Treatment interruption was defined as missing a dose for at least 1 day but for <8 consecutive weeks; the subset 'severe interruption' was defined as missing doses for 2-8 consecutive weeks. RESULTS: Of 110 patients, 75 (68%) interrupted treatment; 19 (17%) reported severe interruption, with a median duration of 30 days. Of the 110 patients, 26 (24%) received injections from family members and 55 (50%) received DOT, 7 (13%) from village doctors and 48 (87%) from family members. Patients who underwent DOT with a family member had less severe interruptions (OR 0.25, 95%CI 0.05-0.98) than those who were given DOT by a village doctor or who did not undergo DOT. CONCLUSIONS: Family members may act as treatment supporters for MDR-TB patients to reduce treatment interruptions, but require orientation on their role.
引用
收藏
页码:413 / 419
页数:7
相关论文
共 31 条
[1]   Integrated, home-based treatment for MDR-TB and HIV in rural South Africa: an alternate model of care [J].
Brust, J. C. M. ;
Shah, N. S. ;
Scott, M. ;
Chaiyachati, K. ;
Lygizos, M. ;
van der Merwe, T. L. ;
Bamber, S. ;
Radebe, Z. ;
Loveday, M. ;
Moll, A. P. ;
Margot, B. ;
Lalloo, U. G. ;
Friedland, G. H. ;
Gandhi, N. R. .
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, 2012, 16 (08) :998-1004
[2]   Emergence of Increased Resistance and Extensively Drug-Resistant Tuberculosis Despite Treatment Adherence, South Africa [J].
Calver, Alistair D. ;
Falmer, Alecia A. ;
Murray, Megan ;
Strauss, Odelia J. ;
Streicher, Elizabeth M. ;
Hanekom, Madelene ;
Liversage, Thelma ;
Masibi, Mothusi ;
van Helden, Paul D. ;
Warren, Robin M. ;
Victor, Thomas C. .
EMERGING INFECTIOUS DISEASES, 2010, 16 (02) :264-271
[3]   A poor drug-resistant tuberculosis programme is worse than no programme: time for a change [J].
Chiang, C-Y ;
Van Deun, A. ;
Enarson, D. A. .
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, 2013, 17 (06) :714-718
[4]   A Systematic Review of the Cost and Cost Effectiveness of Treatment for Multidrug-Resistant Tuberculosis [J].
Fitzpatrick, Christopher ;
Floyd, Katherine .
PHARMACOECONOMICS, 2012, 30 (01) :63-80
[5]   Follow-Up of Patients with Multidrug Resistant Tuberculosis Four Years after Standardized First-Line Drug Treatment [J].
He, Guang Xue ;
Xie, Yan Guang ;
Wang, Li Xia ;
Borgdorff, Martien W. ;
van der Werf, Marieke J. ;
Fan, Ji Huan ;
Yan, Xing Lu ;
Li, Fa Bin ;
Zhang, Xue Zhi ;
Zhao, Yan Lin ;
van den Hof, Susan .
PLOS ONE, 2010, 5 (05)
[6]   Prevalence of tuberculosis drug resistance in 10 provinces of China [J].
He, Guang Xue ;
Zhao, Yan Lin ;
Jiang, Guang Lu ;
Liu, Yu Hong ;
Xia, Hui ;
Wang, Sheng Fen ;
Wang, Li Xia ;
Borgdorff, Martien W. ;
van der Werf, Marieke J. ;
van den Hof, Susan .
BMC INFECTIOUS DISEASES, 2008, 8 (1)
[7]   Direct observation and adherence to tuberculosis treatment in Chongqing, China: a descriptive study [J].
Hu, Daiyu ;
Liu, Xiaoyun ;
Chen, Jing ;
Wang, Yang ;
Wang, Tao ;
Zeng, Wei ;
Smith, Helen ;
Garner, Paul .
HEALTH POLICY AND PLANNING, 2008, 23 (01) :43-55
[8]   Treatment Outcomes of Multidrug-Resistant Tuberculosis: A Systematic Review and Meta-Analysis [J].
Johnston, James C. ;
Shahidi, Neal C. ;
Sadatsafavi, Mohsen ;
Fitzgerald, J. Mark .
PLOS ONE, 2009, 4 (09)
[9]   Costs and cost-effectiveness of different DOT strategies for the treatment of tuberculosis in Pakistan [J].
Khan, MA ;
Walley, JD ;
Witter, SN ;
Imran, A ;
Safdar, N .
HEALTH POLICY AND PLANNING, 2002, 17 (02) :178-186
[10]  
Leimane V, 2005, LANCET, V365, P318, DOI 10.1016/S0140-6736(05)17786-1