Health Systems Research Unit, Medical Research Council of South Africa, Cape Town, South Africa.
Int J Tuberc Lung Dis. 2011 Jan;15(1):84-9, i.
Better integration of treatment support for people living with tuberculosis (TB) and human immuno-deficiency virus/acquired immune-deficiency syndrome (HIV/AIDS) is a challenge in many settings, and has been identified as a service priority.
To determine the impact, compared to directly observed therapy, of a TB treatment intervention modelled on the community antiretroviral treatment (ART) support programme in South Africa.
An interrupted time-series design was used, including five intervention clinics and five comparison clinics. Data were collected from January 2005 to March 2008 and analysed using Poisson regression.
Between April 2007 and March 2008, a total of 71% of all new TB patients starting treatment at the intervention clinics were placed on the intervention. There were no significant differences in cure or treatment success rates for new TB patients between intervention and comparison clinics. There was a small improvement in smear conversion rates in intervention clinics when compared to comparison clinics.
The new model does not result in significantly different TB cure and treatment success rates, but does result in small improvements in smear conversion rates for smear-positive TB patients. The model holds potential for the better integration of TB and ART support.
在许多情况下，更好地整合针对结核病（TB）和人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）感染者的治疗支持是一项挑战，并且已被确定为服务重点。
评估一种基于南非社区抗逆转录病毒治疗（ART）支持计划的结核病治疗干预措施与直接观察治疗相比的效果。
采用了中断时间序列设计，包括五个干预诊所和五个对照诊所。数据收集于 2005 年 1 月至 2008 年 3 月，采用泊松回归进行分析。
在 2007 年 4 月至 2008 年 3 月期间，干预诊所中开始治疗的所有新结核病患者中，有 71%接受了干预措施。干预诊所和对照诊所的新结核病患者的治愈率或治疗成功率没有显著差异。与对照诊所相比，干预诊所的痰涂片转化率略有提高。
新模式并未导致结核病治愈率和治疗成功率有显著差异，但确实使痰涂片阳性结核病患者的痰涂片转化率略有提高。该模式为更好地整合结核病和 ART 支持提供了潜力。
