肯尼亚恩布县部分医疗机构中，直接观察治疗策略下影响结核病患者完成治疗知识掌握情况的因素
Factors influencing knowledge on completion of treatment among TB patients under directly observed treatment strategy, in selected health facilities in Embu County, Kenya.
作者信息
Ndwiga Joshua Muriuki, Kikuvi Gideon, Omolo Jared Odhiambo
机构信息
School of Public Health, Jomo Kenyatta University of Agriculture and Technology, P.O.BOX 62000-00200 Nairobi, Kenya.
Field Epidemiology and Laboratory Training Program, Ministry of Public Health and Sanitation Kenya P.O. Box 225-00202 Nairobi, Kenya.
出版信息
Pan Afr Med J. 2016 Dec 13;25:234. doi: 10.11604/pamj.2016.25.234.8761. eCollection 2016.
INTRODUCTION
The World Health Organization (WHO) promotes the Directly Observed Treatment (DOT) strategy as the standard to increase adherence to Tuberculosis (TB) medication. However, cases of retreatment and Multi Drug Resistant continue to be reported in many parts of Kenya. This study sought to determine the factors influencing the completion of tuberculosis medication among TB patients in Embu County, Kenya.
METHODS
A descriptive cross-sectional study was conducted on a population of tuberculosis patients under DOT attending selected TB treatment clinics in Embu County, in Kenya. One hundred and forty TB patients interviewed within a period of 3 months. Data were analyzed using SPSS version 17.0 and included Bivariate and Multivariate Analysis. The level of significance was p≤ 0.05.
RESULTS
The male and female participants were 61.4% and 38.6% respectively. The mean age of the respondents was 35±31.34-39.3 years. For the majority (52%) of the participants, the highest level of education was primary education. The unemployed participants formed the highest number of the respondent in the study (73%). The majorities (91.4%0) of the respondents were under the home-based DOT strategy (91.4%, 95% C.I: 85.5-95.5). Bivariate analysis using Chi-square showed that the level of education (p=0.003), patients feeling uncomfortable during supervision (p=0.01), and knowledge regarding the frequency of taking medication (p=0.004) were all significantly associated with knowledge regarding the importance of completion of medication. However, none of these factors was significant after multivariate analysis.
CONCLUSION
Most participants did not know the importance of completion of medication. TB programs should come up with better ways to educate TB patients on the importance of supervision and treatment completion during the treatment of TB. The education programs should focus on influencing the attitudes of patients and creating awareness about the importance of treatment completion. The TB programs should be designed towards eliminating the factors influencing the completion of TB medication.
引言
世界卫生组织（WHO）推行直接观察治疗（DOT）策略，将其作为提高结核病（TB）药物治疗依从性的标准。然而，肯尼亚许多地区仍不断有复治和耐多药病例报告。本研究旨在确定影响肯尼亚恩布县结核病患者完成结核病药物治疗的因素。
方法
对肯尼亚恩布县选定结核病治疗诊所中接受直接观察治疗的结核病患者群体进行描述性横断面研究。在3个月内对140名结核病患者进行了访谈。使用SPSS 17.0软件对数据进行分析，包括双变量和多变量分析。显著性水平为p≤0.05。
结果
男性和女性参与者分别占61.4%和38.6%。受访者的平均年龄为35±31.34 - 39.3岁。对于大多数（52%）参与者来说，最高教育水平是小学教育。失业参与者在研究中占受访者的比例最高（73%）。大多数（91.4%）的受访者采用家庭直接观察治疗策略（91.4%，95%置信区间：85.5 - 95.5）。使用卡方检验的双变量分析表明，教育水平（p = 0.003）、患者在监督期间感到不适（p = 0.01）以及关于服药频率的知识（p = 0.004）均与关于完成药物治疗重要性的知识显著相关。然而，多变量分析后这些因素均无显著性。
结论
大多数参与者不知道完成药物治疗的重要性。结核病防治项目应想出更好的方法，在结核病治疗期间对结核病患者进行关于监督和完成治疗重要性的教育。教育项目应侧重于影响患者的态度，并提高对完成治疗重要性的认识。结核病防治项目应旨在消除影响结核病药物治疗完成的因素。
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