Valencia Celina I, Ernst Kacey, Rosales Cecilia Ballesteros
Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
Front Public Health. 2017 May 24;5:118. doi: 10.3389/fpubh.2017.00118. eCollection 2017.
Tuberculosis (TB) remains a salient public health issue along the U.S./Mexico border. This study seeks to identify the social and structural factors, which are associated with TB disease burden in the binational geographic region. Identification of barriers of treatment completion provides the necessary framework for developing evidence-based interventions that are culturally relevant and context specific for the U.S./Mexico border region.
Retrospective study of data extracted from medical charts ( = 439) from Yuma County Health Department (YCHD) ( = 160) and Centro de Salud San Luis Río Colorado ( = 279). Patients currently accessing TB treatment at either facility were excluded from the study. Chi-square, unadjusted odds ratios, and logistic regression were utilized to identify characteristics associated with successful TB treatment in this population.
The study population was predominantly male ( = 327). Females were more likely to complete TB treatment (OR = 3.71). The absence of drug use and/or the absence of an HIV positive diagnosis were found to be predictors of TB treatment completion across both clinical sites. Forty-four percent (43.59%) ( = 85) TB patients treated at CDS San Luis did not complete treatment versus 40.35% ( = 49) of TB patients who did not complete treatment at YCHD. Moving from the area or being deported was the highest category (20.78%) for incomplete TB treatment in the population ( = 64) across both clinical sites.
结核病在美国/墨西哥边境地区仍然是一个突出的公共卫生问题。本研究旨在确定与该两国地理区域结核病负担相关的社会和结构因素。确定治疗完成的障碍为制定基于证据的干预措施提供了必要框架，这些干预措施在文化上具有相关性且针对美国/墨西哥边境地区的具体情况。
对从尤马县卫生部门（YCHD）（n = 160）和圣路易斯里科罗拉多健康中心（n = 279）的病历中提取的数据进行回顾性研究。目前在这两个机构接受结核病治疗的患者被排除在研究之外。使用卡方检验、未调整的优势比和逻辑回归来确定该人群中与结核病治疗成功相关的特征。
研究人群以男性为主（n = 327）。女性更有可能完成结核病治疗（优势比 = 3.71）。发现在两个临床地点，不使用毒品和/或未确诊为艾滋病毒阳性是结核病治疗完成的预测因素。在圣路易斯CDS接受治疗的结核病患者中有44%（43.59%）（n = 85）未完成治疗，而在YCHD未完成治疗的结核病患者为40.35%（n = 49）。在两个临床地点的人群（n = 64）中，离开该地区或被驱逐是结核病治疗未完成的最高类别（20.78%）。
