Kopanoff D E, Snider D E, Johnson M
Division of Tuberculosis Control, Centers for Disease Control, Atlanta, GA 30333.
Am J Public Health. 1988 Jan;78(1):30-3. doi: 10.2105/ajph.78.1.30.
In October 1983, a retrospective survey was initiated to determine if patients reported to the Centers for Disease Control as having recurrent tuberculosis truly had recurrent disease and, if so, why they had developed tuberculosis again. Twenty-three health jurisdictions provided information on 800 patients diagnosed as having recurrent tuberculosis during 1981 and 1982. We found that 199 (25 per cent) of the cases did not meet the criteria for recurrent disease. Of the remaining 601 recurrent cases, 20 per cent had no chemotherapy prescribed for their previous episodes of tuberculosis, 20 per cent were prescribed inadequate or inappropriate therapy, and 33 per cent were not compliant with their prescribed therapy regimens. Patients who, during their original episode of tuberculosis, received the major portion of their medical care from physicians in private practice were more compliant than those treated by other health care providers. However, those same patients were more likely to have received inappropriate therapy than patients treated by other providers. Better patient and physician education, closer monitoring, and greater use of preventive therapy and directly observed therapy are necessary to resolve these problems.
1983年10月，开展了一项回顾性调查，以确定向疾病控制中心报告患有复发性结核病的患者是否真的患有复发性疾病，如果是，他们再次患结核病的原因是什么。23个卫生辖区提供了1981年至1982年期间诊断为复发性结核病的800名患者的信息。我们发现，199例（25%）病例不符合复发性疾病的标准。在其余601例复发病例中，20%在之前的结核病发作时未接受化疗，20%接受的治疗不足或不适当，33%未遵守规定的治疗方案。在最初患结核病期间，大部分医疗护理由私人执业医生提供的患者比由其他医疗服务提供者治疗的患者更遵守治疗方案。然而，与其他医疗服务提供者治疗的患者相比，这些患者更有可能接受不适当的治疗。为解决这些问题，需要加强患者和医生教育、密切监测，并更多地使用预防性治疗和直接观察治疗。
