旧金山潜伏性结核感染直接观察预防治疗的效果
Effect of directly observed preventive therapy for latent tuberculosis infection in San Francisco.
作者信息
White M C, Gournis E, Kawamura M, Menendez E, Tulsky J P
机构信息
Community Health Systems, University of California, San Francisco 94143-0608, USA.
出版信息
Int J Tuberc Lung Dis. 2003 Jan;7(1):30-5.
SETTING
San Francisco TB Clinic instituted a directly observed preventive therapy (DOPT) program for treatment of persons with latent TB infection in 1996.
OBJECTIVE
To examine therapy completion for latent tuberculosis infection before and after implementation of the DOPT program.
DESIGN
Medical records were analyzed for patients at the San Francisco TB Clinic referred from high-risk sites for the periods 1993-1994 (n = 619) and 1997-June 1998 (n = 460). Treatment completion and time of therapy were analyzed comparing DOPT to self-administered therapy (SAT).
RESULTS
More DOPT patients completed treatment (70.3%) than SAT patients (47.9%) (P < 0.001). Controlling for sex, age, race/ethnic group and cohort, patients on DOPT were nearly twice as likely to complete therapy (OR 1.93, 95% CI 1.25-3.00).
CONCLUSION
DOPT is a successful strategy. Combined with targeted testing, DOPT can have an important impact in areas with traditionally low rates of treatment adherence.
背景
旧金山结核病诊所于1996年设立了直接观察下的预防治疗（DOPT）项目，用于治疗潜伏性结核感染患者。
目的
研究DOPT项目实施前后潜伏性结核感染治疗的完成情况。
设计
对1993 - 1994年（n = 619）和1997年 - 1998年6月（n = 460）期间从高危地点转诊至旧金山结核病诊所的患者的病历进行分析。比较DOPT与自我给药治疗（SAT）的治疗完成情况和治疗时间。
结果
完成治疗的DOPT患者（70.3%）多于SAT患者（47.9%）（P < 0.001）。在控制性别、年龄、种族/族裔群体和队列因素后，接受DOPT治疗的患者完成治疗的可能性几乎是SAT患者的两倍（OR 1.93，95% CI 1.25 - 3.00）。
结论
DOPT是一种成功的策略。与针对性检测相结合，DOPT可在传统治疗依从率较低的地区产生重要影响。
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