Sukrakanchana-Trikham P, Puéchal X, Rigal J, Rieder H L
Médecins sans Frontières Tuberculosis Programme, Khao-I-Dang, Prachinburi, Thailand.
Tuber Lung Dis. 1992 Dec;73(6):384-7. doi: 10.1016/0962-8479(92)90045-l.
Tuberculosis control among displaced persons is fraught with difficulties to ensure adherence of patients to treatment for a prolonged period of time. In the Khao-I-Dang camp for Cambodian refugees an approach with daily, directly observed treatment throughout the course of 6 months duration was chosen to address the problem. Of a total 929 patients with sputum smear-positive tuberculosis who were enrolled from 1981 to 1990, 5.0% died, 75.5% completed treatment and were bacteriologically cured with a day-to-day adherence of more than 98%, none failed bacteriologically, 19.2% were transferred to another camp where continuation of treatment was guaranteed, and only 0.4% absconded from treatment. These data suggest that the approach to tuberculosis control in this refugee camp was very effective in cutting the chain of transmission of tuberculosis in a highly mobile population and in reducing substantially unnecessary morbidity and mortality.
在流离失所者中控制结核病充满困难，难以确保患者长期坚持治疗。在考艾当柬埔寨难民营，采用了在6个月疗程中每日直接观察治疗的方法来解决这一问题。1981年至1990年共纳入929例痰涂片阳性肺结核患者，其中5.0%死亡，75.5%完成治疗且细菌学治愈，每日治疗依从性超过98%，无细菌学治疗失败病例，19.2%被转移至另一个能保证继续治疗的营地，仅有0.4%擅自中断治疗。这些数据表明，该难民营的结核病控制方法在切断高流动性人群中结核病传播链以及大幅降低不必要的发病率和死亡率方面非常有效。
