Charles P Felton National Tuberculosis Center, International Center for AIDS Care and Treatment Programs, Columbia University, New York, New York 10027, USA.
Int J Tuberc Lung Dis. 2013 Apr;17(4):473-9. doi: 10.5588/ijtld.12.0697.
An estimated 300 000 individuals are treated for latent tuberculosis infection (LTBI) in the United States and Canada annually. Little is known about the proportion or characteristics of those who decline treatment.
To define the proportion of individuals in various groups who accept LTBI treatment and to identify factors associated with non-acceptance of treatment.
Persons offered LTBI treatment at 30 clinics in 12 Tuberculosis Epidemiologic Studies Consortium sites were prospectively enrolled. Multivariate regression models were constructed based on manual stepwise assessment of potential predictors.
Of 1692 participants enrolled from March 2007 to September 2008, 1515 (89.5%) accepted treatment and 177 (10.5%) declined. Predictors of acceptance included believing one could personally spread TB germs, having greater TB knowledge, finding clinic schedules convenient and having low acculturation. Predictors of non-acceptance included being a health care worker, being previously recommended for treatment and believing that taking medicines would be problematic.
This is the first prospective multisite study to examine predictors of LTBI treatment acceptance in general clinic populations. Greater efforts should be made to increase acceptance among health care workers, those previously recommended for treatment and those who expect problems with LTBI medicines. Ensuring convenient clinic schedules and TB education to increase knowledge could be important for ensuring acceptance.
在美国和加拿大，每年约有 30 万人接受潜伏性结核感染（LTBI）的治疗。对于拒绝治疗的人群的比例或特征，人们知之甚少。
确定各个群体中接受 LTBI 治疗的人数比例，并确定与拒绝治疗相关的因素。
在 12 个结核病流行病学研究联盟站点的 30 个诊所中，对接受 LTBI 治疗的人员进行前瞻性登记。基于对潜在预测因素的手动逐步评估，构建了多变量回归模型。
从 2007 年 3 月至 2008 年 9 月登记的 1692 名参与者中，1515 名（89.5%）接受了治疗，177 名（10.5%）拒绝了治疗。接受治疗的预测因素包括相信自己可能会传播结核病菌、具有较高的结核病知识、认为诊所的日程安排方便以及文化程度较低。拒绝治疗的预测因素包括从事医疗工作者、之前被建议进行治疗以及认为服用药物会有问题。
这是首次在一般诊所人群中前瞻性地研究 LTBI 治疗接受度的多站点研究。应加大力度，提高医疗工作者、之前被建议进行治疗以及认为 LTBI 药物存在问题的人群的接受度。确保方便的诊所日程安排和结核病教育以提高知识水平，对于确保接受度可能非常重要。
