Oo M M, Liabsuetrakul T, Boonathapat N, Aung H K K, Pungrassami P
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Mae Sot General Hospital, Mae Sot, Thailand.
Int J Tuberc Lung Dis. 2022 Jun 1;26(6):550-557. doi: 10.5588/ijtld.21.0532.
Two facilities, one providing clinic-based care and another providing residential care to Myanmar migrants with TB, in a Thailand-Myanmar border area. To determine the effects of health insurance, total delay and the model of care on treatment success of TB. A prospective study was conducted among adult Myanmar migrants under treatment for newly diagnosed TB. Effects of health insurance, total delay and model of care on treatment success at completion of 6-month treatment were analysed using multiple logistic regression models. Of 191 Myanmar migrants with TB, 167 (87.4%) had treatment success. Median time delays from symptom onset to treatment initiation among migrants with health insurance receiving clinic-based care were significantly shorter than those without health insurance. Those who received residential care had higher odds of treatment success than those under clinic-based care (aOR 6.0, 95% CI 1.5-23.3); having health insurance (aOR 1.0, 95% CI 0.3-2.9) and total delay (aOR 1.7, 95% CI 0.7-4.2) were not significantly associated with treatment success. A high treatment success rate was associated with receiving residential care among Myanmar migrants with TB on the Thai-Myanmar border. The residential care model, implemented under a non-governmental organisation, was feasible and effective for the migrant population.
在泰国-缅甸边境地区,有两个机构,一个为患有结核病的缅甸移民提供门诊护理,另一个提供住院护理。为了确定医疗保险、总延误时间和护理模式对结核病治疗成功的影响。对新诊断为结核病正在接受治疗的成年缅甸移民进行了一项前瞻性研究。使用多元逻辑回归模型分析了医疗保险、总延误时间和护理模式对6个月治疗结束时治疗成功的影响。在191名患有结核病的缅甸移民中,167人(87.4%)治疗成功。接受门诊护理且有医疗保险的移民从症状出现到开始治疗的中位延误时间明显短于没有医疗保险的移民。接受住院护理的人治疗成功的几率高于接受门诊护理的人(调整后的比值比为6.0,95%置信区间为1.5-23.3);拥有医疗保险(调整后的比值比为1.0,95%置信区间为0.3-2.9)和总延误时间(调整后的比值比为1.7,95%置信区间为0.7-4.2)与治疗成功没有显著关联。在泰缅边境患有结核病的缅甸移民中,高治疗成功率与接受住院护理有关。在一个非政府组织实施的住院护理模式对移民群体是可行且有效的。