Tachfouti Nabil, Slama Katia, Berraho Mohammed, Nejjari Chakib
Laboratory of Epidemiology, Clinical research and Community health. Faculty of Medicine - Fez Morocco.
Pan Afr Med J. 2012;12:52. Epub 2012 Jun 28.
Although tuberculosis (TB) care is provided free of charge in Morocco, a high number of patients voluntarily interrupt their treatment before the end. Treatment Default is a major obstacle in the fight against the disease. The purpose of this study was to describe the impact of knowledge and attitudes toward TB on treatment adherence.
Case-control study of 290 TB patients (85 defaulters and 205 controls). A defaulter was defined as a TB patient who interrupted treatment for two months or longer. Socio-demographic measurements, knowledge and attitude were collected by face to face anonymous questionnaire. Khi-square test was conducted to examine differences in TB attitudes and knowledge according to treatment adherence.
The mean age of participants was 31.7 ± 12.0 years. Monthly income was under 2000 MAD (180 €) for 82% of them. Over sixty four percent were illiterate or had a basic educational level. Microbial cause was known by 17.2% respondents; 20.5% among adherent patients versus 9.4% (p=0.02). The fact that the disease is curable was more known by adherent patients: 99.0% versus 88.2% (p < 0.01). Eighty tree per cent of patients had been informed about treatment duration and consequences of not completing treatment: 89.0% among adherent patients versus 69.7% (p<0.001). The main reason evoked for defaulting was the sensation of being cured (72.9% of defaulters).
This study shows a poor knowledge on TB especially among non adherent patients. This finding justifies the need to incorporate patient's education into current TB case management.
尽管摩洛哥提供免费的结核病（TB）治疗，但仍有大量患者在疗程结束前自愿中断治疗。治疗中断是抗击该疾病的主要障碍。本研究的目的是描述对结核病的认知和态度对治疗依从性的影响。
对290例结核病患者进行病例对照研究（85例治疗中断者和205例对照）。治疗中断者定义为中断治疗两个月或更长时间的结核病患者。通过面对面匿名问卷调查收集社会人口统计学数据、认知和态度。采用卡方检验来检验根据治疗依从性在结核病态度和认知方面的差异。
参与者的平均年龄为31.7±12.0岁。其中82%的人月收入低于2000摩洛哥迪拉姆（180欧元）。超过64%的人是文盲或只有基础教育水平。17.2%的受访者知道微生物病因；坚持治疗的患者中有20.5%，而治疗中断者中为9.4%（p = 0.02）。坚持治疗的患者更了解该病可治愈这一事实：分别为99.0%和88.2%（p < 0.01）。83%的患者被告知治疗疗程以及未完成治疗的后果：坚持治疗的患者中有89.0%，而治疗中断者中为69.7%（p < 0.001）。治疗中断的主要原因是感觉已治愈（72.9%的治疗中断者）。
本研究表明对结核病的认知较差，尤其是在未坚持治疗的患者中。这一发现证明有必要将患者教育纳入当前的结核病病例管理中。
