Deshmukh P R, Mundra A, Dawale A
Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, India.
District Health Office, Zila Parishad, Wardha, India.
Int J Tuberc Lung Dis. 2017 Aug 1;21(8):941-946. doi: 10.5588/ijtld.16.0919.
'Social capital' refers to social norms, relationships, networks and values that affect the functioning and development of society. Social capital influences health positively, but its role in the treatment outcomes of tuberculosis (TB) is not known.
To study the role of social capital in determining adverse TB treatment outcomes.
Of 516 patients registered under the Revised National Tuberculosis Control Programme in 2014 in Wardha Tuberculosis Unit, Wardha, India, we included 88 patients with adverse treatment outcomes as cases and 187 controls from among those without adverse outcomes. Multiple logistic regression was used to compare standardised Z-scores.
A greater proportion of controls than cases belonged to higher quartiles of social capital and its domains than cases, and the mean standardised Z-score was also consistently higher among controls than cases. Respectively 47% and 15% of cases and controls were in the poorest quartile of social capital, whereas respectively 10% and 33% of cases and controls were in the richest quartile. Each unit increase in Z-score of overall social capital reduced the odds of adverse treatment outcomes by 63.1%.
Appropriate interventions for building social capital for TB patients and linking them with the programme would improve programme performance.
“社会资本”指的是影响社会功能和发展的社会规范、关系、网络及价值观。社会资本对健康有积极影响，但其在结核病（TB）治疗结果中的作用尚不清楚。
研究社会资本在决定结核病不良治疗结果中的作用。
在印度瓦尔道结核病防治单位，2014年根据修订的国家结核病控制规划登记的516例患者中，我们纳入了88例有不良治疗结果的患者作为病例组，以及187例无不良结果的患者作为对照组。采用多元逻辑回归比较标准化Z分数。
与病例组相比，对照组中属于社会资本及其各领域较高四分位数的比例更大，且对照组的平均标准化Z分数也始终高于病例组。病例组和对照组分别有47%和15%处于社会资本最贫困的四分位数，而病例组和对照组分别有10%和33%处于最富裕的四分位数。总体社会资本Z分数每增加一个单位，不良治疗结果的几率降低63.1%。
针对结核病患者建立社会资本并将他们与该项目联系起来的适当干预措施将改善项目效果。
