Herrero María Belén, Ramos Silvina, Arrossi Silvina
Centro de Estudios de Estado y Sociedad, Ciudad Autónoma de Buenos Aires, Argentina.
Rev Bras Epidemiol. 2015 Apr-Jun;18(2):287-98. doi: 10.1590/1980-5497201500020001.
To identify the association between non-adherence to tuberculosis treatment and access to treatment.
A cross-sectional study was carried out in the Metropolitan Area of Buenos Aires, Argentina. One hundred twenty three patients notified in 2007 (38 non adherent and 85 adherents) were interviewed regarding the health care process and socio-demographic characteristics. Factors associated to non-adherence were assessed through logistic regression analysis.
An increased risk of non-adherence with to treatment was found in male patients (OR = 2.8; 95%CI 1.2 - 6.7), patients who had medical check-ups at hospitals (OR = 3.4; 95%CI 1.1 - 10.0) and those who had difficulties with transportation costs (OR = 2.5; 95%CI 1.1 - 5.9).
Risk of non-adherence increases as a result of economic barriers in accessing health care facilities. Decentralization of treatment to primary health care centers and social protection measures for patients should be considered as priorities for disease control strategies in order to lessen the impact of those barriers on adherence to treatment.
确定结核病治疗不依从性与治疗可及性之间的关联。
在阿根廷布宜诺斯艾利斯都会区开展了一项横断面研究。就医疗保健过程和社会人口学特征对2007年报告的123例患者（38例不依从者和85例依从者）进行了访谈。通过逻辑回归分析评估与不依从相关的因素。
发现男性患者（比值比=2.8；95%置信区间1.2 - 6.7）、在医院进行体检的患者（比值比=3.4；95%置信区间1.1 - 10.0）以及那些在交通费用方面有困难的患者（比值比=2.5；95%置信区间1.1 - 5.9）治疗不依从的风险增加。
由于获得医疗保健设施存在经济障碍，不依从风险增加。为减少这些障碍对治疗依从性的影响，应将治疗下放到初级卫生保健中心以及为患者提供社会保护措施视为疾病控制策略的优先事项。
