Dept. of Community Medicine, Maulana Azad Medical College, New Delhi, India.
Dept. of Community Medicine, Maulana Azad Medical College, New Delhi, India.
Indian J Tuberc. 2020 Apr;67(2):208-212. doi: 10.1016/j.ijtb.2020.02.003. Epub 2020 Feb 24.
More than one in two healthcare workers (HCWs) in developing countries have latent tuberculosis infection (LTBI), an asymptomatic condition signifying persistent tubercular infection in absence of disease.
to evaluate the physician attitude towards LTBI preventive therapy and their perspectives regarding the potential expansion of latent TB management under the RNTCP.
We conducted a cross-sectional analysis among 60 participants of a continuing medical education program during October' 2019 in a medical college in Delhi, India.
We enrolled a total of 30 medical officers, 15 resident doctors and 15 medical interns, comprising 27 (45%) males and 33 (55%) females. Only 9 (15%) participants were aware of existing RNTCP guidelines for programmatic management of LTBI. The median (IQR) self-rated willingness of the participants in receiving treatment for LTBI after confirmation of diagnosis on a 10 point continuous rating scale was 6 (5.8). The principal reason attributed to the treatment hesitancy were concerns over drug side effects 19 (31.7%), emergence of drug resistance 11 (18.3%) and the likelihood of reinfection 4 (6.7%). Support for expansion of preventive therapy among household TB contacts was varied, with maximum (41.2%) participants wanting it only for the comorbid patients.
LTBI preventive treatment is associated with considerable side effects and lack of long-term benefits by a majority of Indian physicians despite significant personal health concerns in treating pulmonary TB cases.
发展中国家超过一半的医护人员（HCWs）患有潜伏性结核感染（LTBI），这是一种无症状的状态，表明在没有疾病的情况下存在持续的结核感染。
评估医生对 LTBI 预防性治疗的态度，以及他们对 RNTCP 下潜在扩大潜伏性 TB 管理的看法。
我们在印度德里的一所医学院，于 2019 年 10 月期间对 60 名继续医学教育计划的参与者进行了横断面分析。
我们共招募了 30 名医疗官、15 名住院医生和 15 名实习医生，其中包括 27 名（45%）男性和 33 名（55%）女性。只有 9 名（15%）参与者了解现有的 RNTCP 指南，用于 LTBI 的方案管理。参与者在确认诊断后，根据 10 点连续评分量表，对自己接受 LTBI 治疗的意愿进行评分，中位数（IQR）为 6（5.8）。导致治疗犹豫不决的主要原因是担心药物副作用 19 例（31.7%）、药物耐药性出现 11 例（18.3%）和再次感染的可能性 4 例（6.7%）。对家庭性结核病接触者扩大预防性治疗的支持程度不一，最多（41.2%）的参与者仅希望对合并症患者进行治疗。
尽管在治疗肺结核病例时个人健康方面存在重大顾虑，但印度的大多数医生认为 LTBI 预防性治疗存在相当大的副作用，且缺乏长期益处。
