Xu Zuhui, Xiao Tao, Li Yanhong, Yang Kunyun, Tang Yi, Bai Liqiong
Department of tuberculosis control, Tuberculosis Control Institute of Hunan Province, Changsha city, Hunan province, China.
Department of MDR-TB internal medicine, Hunan Chest hospital, Changsha city, Hunan province, China.
PLoS One. 2017 Jan 23;12(1):e0170718. doi: 10.1371/journal.pone.0170718. eCollection 2017.
In 2015, only 49% of notified multi-drug resistant tuberculosis (MDR-TB) patients in China were estimated to have initiated treatment, compared with 90% of those worldwide. A case-control study was conducted to identify the reasons for non-enrollment in treatment among MDR-TB patients in Hunan province, China. All detected MDR-TB patients registered in designated MDR-TB hospitals in Hunan province from 2011 to 2014 were included and followed until June 2015 to determine their treatment status. Approximately 33.8% (482/1425) of patients were not enrolled in standardized treatment. Factors associated with lower enrollment rate were: age greater than 60 years, living in rural area, unemployed or occupation unreported. Of those who were not enrolled in MDR-TB treatment, the primary reasons for non-enrollment included economic hardship (23.0%), out-migration for work (18.0%), concerns about work and studies (13.7%), and the belief that they were cured after undergoing drug-sensitive TB treatment (12.4%). Therefore, comprehensive strategies targeting priority populations, especially those enhancing treatment affordability and availability, need to be implemented to improve MDR-TB control.
2015年，据估计中国报告的耐多药结核病（MDR-TB）患者中仅有49%开始接受治疗，而全球这一比例为90%。在中国湖南省开展了一项病例对照研究，以确定耐多药结核病患者未登记接受治疗的原因。纳入了2011年至2014年在湖南省指定耐多药结核病医院登记的所有已检测出的耐多药结核病患者，并对其进行随访直至2015年6月，以确定他们的治疗状况。约33.8%（482/1425）的患者未登记接受标准化治疗。与登记率较低相关的因素有：年龄大于60岁、居住在农村地区、失业或职业未报告。在未登记接受耐多药结核病治疗的患者中，未登记的主要原因包括经济困难（23.0%）、外出务工（18.0%）、担心工作和学习（13.7%）以及认为接受敏感结核病治疗后已治愈（12.4%）。因此，需要实施针对重点人群的综合策略，尤其是那些提高治疗可及性和可负担性的策略，以改善耐多药结核病防控工作。
