Khatana Ghulam Hassan, Masoodi Muneer, Amin Mariya
Medical Officer, Health Services, Government of Jammu & Kashmir, India.
Professor, Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India.
Indian J Tuberc. 2017 Jul;64(3):189-195. doi: 10.1016/j.ijtb.2017.01.011. Epub 2017 Mar 16.
There are various biological, behavioural and social determinants associated with the epidemiology of pulmonary tuberculosis (P-TB) which have been extensively described in literature. Present study was conducted to know the influence of such factors on the "home-based interventional model" for active case finding among household contacts of index P-TB cases.
In a quasi-randomized controlled interventional study, the "home-based interventional model" for active case finding was applied to index P-TB cases and their household contacts of interventional group of study subjects. Study was conducted from January 2014 to June 2015 for evaluation of the model in comparison to the existing usual practice of contact tracing. Baseline data regarding factors associated with epidemiology of P-TB likely to influence effectiveness of intervention were collected, collated and analysed.
The overall acceptance of intervention was 70.74% which was statically significantly influenced by gender (p<0.0001), age group (p=0.0006), education (p<0.0001), occupation (p<0.0001) and relationship of household contacts with index case (p<0.0001). Total 27 (4.51%) cases were detected among contacts. Out of personal and family level characteristics "relationship with index case" (p=0.0418) and "overcrowding in house" (p=0.0017) were found to statistically significantly influencing the effectiveness of interventional model. The prevalent risk factors for TB among contacts, level of exposer of household contacts to index cases, grade sputum positivity and type of index case were not found statistically significantly influencing the yield of interventional model.
Factors/determinants influencing the applicability of interventional model for active case finding among household contacts were identified and their impact on acceptance and yield of intervention was assessed.
与肺结核（P-TB）流行病学相关的各种生物、行为和社会决定因素在文献中已有广泛描述。本研究旨在了解这些因素对P-TB索引病例家庭接触者中活动性病例发现的“家庭干预模式”的影响。
在一项半随机对照干预研究中，将用于活动性病例发现的“家庭干预模式”应用于研究对象干预组的P-TB索引病例及其家庭接触者。研究于2014年1月至2015年6月进行，以评估该模式，并与现有的常规接触者追踪做法进行比较。收集、整理和分析了与P-TB流行病学相关的、可能影响干预效果的因素的基线数据。
干预的总体接受率为70.74%，性别（p<0.0001）、年龄组（p=0.0006）、教育程度（p<0.0001）、职业（p<0.0001）以及家庭接触者与索引病例的关系（p<0.0001）对其有统计学显著影响。在接触者中总共检测出27例（4.51%）病例。在个人和家庭层面特征中，“与索引病例的关系”（p=0.0418）和“房屋拥挤”（p=0.0017）被发现对干预模式的有效性有统计学显著影响。未发现接触者中结核病的流行危险因素、家庭接触者与索引病例的接触程度、痰涂片阳性等级和索引病例类型对干预模式的检出率有统计学显著影响。
确定了影响家庭接触者中活动性病例发现干预模式适用性的因素/决定因素，并评估了它们对干预接受率和检出率的影响。
