Horo K, Kouassi A B, Brou-Gode C V, Ahui J-M B, Diaw A, Kone-Konate F, Toure K, Gnaze A Z, N'Gom S A, Koffi B N, Aka-Danguy E
Service de pneumologie du CHU de Cocody, BP 582 Abidjan cedex 03, Côte d'Ivoire.
Rev Mal Respir. 2011 Sep;28(7):894-902. doi: 10.1016/j.rmr.2011.01.012. Epub 2011 Jun 23.
Patients with contagious tuberculosis who are lost to follow-up risk sowing the disease among their circle of acquaintances. Moreover, a history of inadequate anti-tuberculous treatment is an important risk factor for the development of drug-resistant organisms. The purpose of this study was to identify risk factors for loss to follow-up among patients undergoing treatment for tuberculosis.
We performed a prospective cohort study among patients with contagious tuberculosis, beginning with anti-tuberculous treatment followed during six months, after initial education-information about their condition. We compared the characteristics of 152 patients lost to follow-up from tuberculosis treatment against those of 492 patients who were not lost to follow-up.
Independent factors associated with a reduction in the risk of being lost to follow-up were: the presence of night-sweats (OR=0.46 [0.24-0.88]; P=0.018), the presence of thoracic pain (OR=0.27 [0.14-0.54]; P<0.001), screening for HIV (OR=0.41 [0.17-0.98]; P=0.045), fact to inform a person of its disease (OR=0.06 [0.01-0.41]; P=0.004), the application of directly observed treatment in the community (OR=0.34 [0.17-0.66]; P<0.001).
Reducing loss to follow-up during treatment for tuberculosis requires the development of a "good attitude" through education-information about tuberculosis.
失访的传染性结核病患者有将疾病传播给其熟人圈子的风险。此外，抗结核治疗不充分的病史是耐药菌产生的重要危险因素。本研究的目的是确定结核病治疗患者失访的危险因素。
我们对传染性结核病患者进行了一项前瞻性队列研究，从抗结核治疗开始，在最初告知患者病情相关信息后随访6个月。我们比较了152例结核病治疗失访患者与492例未失访患者的特征。
与降低失访风险相关的独立因素包括：盗汗（比值比[OR]=0.46[0.24-0.88]；P=0.018）、胸痛（OR=0.27[0.14-0.54]；P<0.001）、HIV筛查（OR=0.41[0.17-0.98]；P=0.045）、告知他人自己病情这一事实（OR=0.06[0.01-0.41]；P=0.004）、在社区实施直接观察治疗（OR=0.34[0.17-0.66]；P<0.001）。
减少结核病治疗期间的失访需要通过结核病相关的教育信息培养“良好态度”。
