Workie Moges Getie, Aycheh Moges Wubie, Birhanu Molla Yigzaw, Tsegaye Tesfa Birlew
Public Health, Ari Primary Hospital, Gazer, Southern Nations, Nationalities, and Peoples' Region, Ethiopia.
Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Patient Prefer Adherence. 2021 May 26;15:1143-1151. doi: 10.2147/PPA.S307091. eCollection 2021.
Tuberculosis treatment interruption is a failure of attending two scheduled appointments to collect the drugs in either phase of tuberculosis treatment. Even if TB treatment is crucial to achieve a cure and avoid the emergence of drug resistance, treatment interruption is the most testing and deterring factor for successful tuberculosis treatment and one of the problems leading to the development of drug-resistant tuberculosis. TB treatment interruption is the precursor for loss to follow-up and treatment failure, but the magnitude of this problem is unknown in Ethiopia. Thus, this study was intended to identify determinants of treatment interruption among drug-susceptible pulmonary tuberculosis patients in South Ari district, Southern Ethiopia.
An institution-based unmatched case control study was conducted from February through April 2020 using 255 samples with a ratio of 2:1 (controls to cases). Data were entered into Epi data version 4.2 and exported for analysis using STATA 14.0 statistical software. The variables having a p-value of less than 0.25 in the bivariable analysis were subjected to multivariable logistic regression analysis. In multivariable logistic regression analysis, AORs, 95% CIs, and p-values of <0.05 were used to identify significant variables.
The median age was 34 (IQR: 18) years in cases and 29 (IQR: 16) years in control groups. Significant factors that were associated with treatment interruption were alcohol consumption (AOR = 2.99, 95% CI; 1.41-6.36); smoking habits (AOR = 2.82, 95% CI; 1.14-6.94); use of traditional medicine (AOR = 2.35, 95% CI 1.05-5.24); co-infected with HIV (AOR=1.58, 95% CI; 1.85-4.29), and waiting time at the health facility ≥30 minutes (AOR = 2.98, 95% CI; 1.31-6.80).
Alcohol consumption, waiting time at the health facility ≥30 minutes, smoking habits, used traditional medicine, and HIV co-infected were potential determinants. Enhancing public health education, designing strategies that emphasize patients with HIV co-infection, and reducing waiting times are recommended.
结核病治疗中断是指在结核病治疗的任何阶段未按预定时间前来领取药物。尽管结核病治疗对于实现治愈和避免耐药性出现至关重要，但治疗中断是成功治疗结核病最具考验性和阻碍性的因素之一，也是导致耐药结核病产生的问题之一。结核病治疗中断是失访和治疗失败的先兆，但在埃塞俄比亚，这个问题的严重程度尚不清楚。因此，本研究旨在确定埃塞俄比亚南部阿瑞地区药物敏感型肺结核患者治疗中断的决定因素。
2020年2月至4月进行了一项基于机构的非匹配病例对照研究，使用255个样本，比例为2:1（对照组与病例组）。数据录入Epi data 4.2版本，并导出使用STATA 14.0统计软件进行分析。在双变量分析中p值小于0.25的变量进行多变量逻辑回归分析。在多变量逻辑回归分析中，使用调整后比值比（AOR）、95%置信区间（CI）和p值<0.05来确定显著变量。
病例组的中位年龄为34岁（四分位间距：18岁），对照组为29岁（四分位间距：16岁）。与治疗中断相关的显著因素包括饮酒（AOR = 2.99，95% CI：1.41 - 6.36）；吸烟习惯（AOR = 2.82，95% CI：1.14 - 6.94）；使用传统药物（AOR = 2.35，95% CI 1.05 - 5.24）；合并感染艾滋病毒（AOR = 1.58，95% CI：1.85 - 4.29），以及在医疗机构等待时间≥30分钟（AOR = 2.98，95% CI：1.31 - 6.80）。
饮酒、在医疗机构等待时间≥30分钟、吸烟习惯、使用传统药物以及合并感染艾滋病毒是潜在的决定因素。建议加强公共卫生教育，制定针对合并感染艾滋病毒患者的策略，并减少等待时间。
