Monique Opperman, Ilse DU Preez
Human Metabolomics, North-West University (Potchefstroom Campus), Private Bag x6001, Box 269, Potchefstroom, South Africa, 2531.
Afr J Infect Dis. 2022 Dec 22;17(1):60-73. doi: 10.21010/Ajidv17i1.6. eCollection 2023.
Despite the available treatment options, pulmonary tuberculosis (TB) remains a leading cause of disease-related deaths worldwide. Treatment non-adherence/lost to follow-up (LTFU), particularly in developing countries, is a continuous concern. LTFU prolongs TB infectiousness and contributes to TB treatment failure, relapse, and death. Furthermore, LTFU also delays global TB eradication by promoting TB spread and drug-resistant TB strain development.[1] The purpose of this paper is to give an overview of the commonly observed risk factors associated with TB treatment LTFU in developing countries.
A literature survey was done of studies published in the past decade, which evaluated the risk factors for LTFU in TB patients, specifically in developing countries. Furthermore, some prospective TB treatment adherence initiatives and the feasibility of these initiatives within developing countries were assessed.[3].
Several variables, including socio-demographic, patient-related, TB disease and other health-related-factors, healthcare and system determinants, as well as treatment-related factors, were identified to increase the risk of TB treatment LTFU. More recently applied adherence interventions in developing countries, show potential for implementation on a larger scale.
Successful TB treatment is contingent on treatment adherence, and by addressing these persisting LTFU risk factors, treatment adherence in developing countries may be improved.
尽管有可用的治疗方案,但肺结核(TB)仍是全球疾病相关死亡的主要原因。治疗不依从/失访(LTFU),尤其是在发展中国家,一直是一个令人担忧的问题。失访会延长结核病的传染性,并导致结核病治疗失败、复发和死亡。此外,失访还会通过促进结核病传播和耐药结核菌株的发展而延迟全球结核病的根除。[1] 本文的目的是概述发展中国家与结核病治疗失访相关的常见风险因素。
对过去十年发表的研究进行了文献调查,这些研究评估了结核病患者,特别是发展中国家患者失访的风险因素。此外,还评估了一些前瞻性结核病治疗依从性倡议以及这些倡议在发展中国家的可行性。[3]
确定了几个变量,包括社会人口统计学、患者相关、结核病疾病和其他健康相关因素、医疗保健和系统决定因素以及治疗相关因素,这些因素会增加结核病治疗失访的风险。发展中国家最近应用的依从性干预措施显示出大规模实施的潜力。
成功的结核病治疗取决于治疗依从性,通过解决这些持续存在的失访风险因素,发展中国家的治疗依从性可能会得到改善。