Ministry of Health, Burkina Faso; International Health Program, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; AIDS Prevention and Research Center, National Yang-Ming University, Taipei, Taiwan.
AIDS Prevention and Research Center, National Yang-Ming University, Taipei, Taiwan.
J Microbiol Immunol Infect. 2014 Jun;47(3):222-32. doi: 10.1016/j.jmii.2013.05.001. Epub 2013 Jun 14.
Adherence to treatment remains a key issue for tuberculosis (TB) and human immunodeficiency virus (HIV) programs. The study objective was to identify potential determinants of medication adherence (MA) among patients with TB, HIV, or both.
In this cross-sectional study, adult patients attending TB or HIV clinics were recruited in two main regions (Centre and Hauts-Bassins) of Burkina Faso from August to October 2010. Questionnaires were collected and simple and multiple step-wise linear regression models were used to identify predictors of MA.
In total, 1043 patients (309 with TB, 553 with HIV, and 181 coinfected with both) participated in this study. For patients with TB, adjusted predictors of good MA were no alcohol use, ever been lost to follow-up, and awareness of disease transmission. For patients with HIV, adjusted predictors of good MA were less stigma, good knowledge about TB transmission, and awareness of disease transmission. For patients with dual infection, adjusted predictors of good MA was good attitude. Furthermore, adjusted predictors of poor MA for patients with TB or with dual infection were poor financial access to care and high number of persons sleeping in the household, respectively.
This study provides information on MA in patients infected with TB, HIV, and those coinfected with TB and HIV. TB and HIV programs have to consider the environment of the patient and its characteristics, including stigma, attitude, status of loss to follow-up, TB knowledge, financial access to care, alcohol use, awareness of disease transmission, and number of persons sleeping in the household. These identified factors in this study need to be taken into account for a specific patient profile and during sensitization, project planning, and research stages.
对于结核病（TB）和人类免疫缺陷病毒（HIV）项目而言，坚持治疗仍然是一个关键问题。本研究旨在确定同时患有 TB、HIV 或两者的患者药物依从性（MA）的潜在决定因素。
在这项横断面研究中，于 2010 年 8 月至 10 月在布基纳法索的两个主要地区（中心和 Hauts-Bassins）招募了参加 TB 或 HIV 诊所的成年患者。收集了问卷，并使用简单和多步逐步线性回归模型来确定 MA 的预测因素。
共有 1043 名患者（309 名患有结核病，553 名患有 HIV，181 名同时感染两者）参加了这项研究。对于患有结核病的患者，良好 MA 的调整预测因素是不饮酒，从未失访以及对疾病传播的认识。对于患有 HIV 的患者，良好 MA 的调整预测因素是较少的耻辱感，对结核病传播的良好认识以及对疾病传播的认识。对于双重感染的患者，良好 MA 的调整预测因素是良好的态度。此外，结核病或双重感染患者 MA 较差的调整预测因素分别是获得医疗服务的经济机会差和家中睡眠人数多。
本研究提供了有关感染 TB、HIV 以及同时感染 TB 和 HIV 的患者 MA 的信息。TB 和 HIV 项目必须考虑患者的环境及其特征，包括耻辱感，态度，失访状况，TB 知识，获得医疗服务的经济机会，饮酒，对疾病传播的认识以及家中睡眠人数。在这项研究中确定的这些因素需要针对特定的患者情况，并在宣传，项目规划和研究阶段中加以考虑。
