Naga Mamo Adisu, Furi Gilo Robdu, Fikadu Tesema Ashetu, Fetene Worku Negash, Teshome Kenea Tadese, Kebede Dibisa Dinka, Adisu Dagafa Yonas, Dube Lamessa
Department of Public Health Emergency Management, Kelem Wallaga Zonal Health Office, Dambi Dollo, Oromia, Ethiopia.
Department of Pediatrics, Shala District Health Office, Shashamane, Oromia, Ethiopia.
Patient Prefer Adherence. 2023 Jul 28;17:1867-1879. doi: 10.2147/PPA.S411685. eCollection 2023.
The greatest risk of getting tuberculosis (TB) infection is contact with patients who have pulmonary tuberculosis (PTB). The World Health Organization (WHO) strongly recommends tuberculosis screening for all household contacts of PTB patients. However, there is no information on household contact screening adherence among PTB patients in Shashamane town.
A facility-based mixed-method cross-sectional study was conducted from July 1 to November 30, 2021 among consecutively selected 392 PTB patients and 23 purposely selected key informants. Data were collected using a pre-tested interviewer administered questionnaire and leading questions. Data analysis was made using SPSS version 25 and in-depth interview information was analyzed based on thematic areas. Bivariable followed by multivariable logistic regression with 95% CI were conducted. -value<0.05 was considered to identify statistically significant factors.
The overall adherence to household contact screening (HHCS) was 44.4% (95% CI: 39.3, 49.1). Having under fifteen years of contact (AOR=2.386, 95% CI: 1.44, 3.96), diploma and above education status (AOR=3.43, 95% CI: 1.286, 9.15), good knowledge (AOR=2.999, 95% CI: 1.79, 5.03), favorable attitude (AOR=2.409, 95% CI: 1.45, 4.02), getting health education (AOR=3.287, 95% CI: 1.92, 5.63) and smear positive type of PTB (AOR=2.156, 95% CI: 1.28, 3.62) were factors significantly associated with HHCS adherence. Workload, facility readiness and care provide commitments were also identified from qualitative data.
HHCS adherence in our study was sub-optimal referenced to WHO and national recommendations that all household contact should be screened. Having age less than fifteen years contact, education status, knowledge, attitude, receiving health education and type of pulmonary tuberculosis were factors associated with adherence. We recommend increasing community awareness of TB, providing health education TB patients and their families, strengthening positive attitudes toward HHC screening and strengthening the commitment of health professionals to screen for HHCs.
感染结核病（TB）的最大风险是与肺结核（PTB）患者接触。世界卫生组织（WHO）强烈建议对所有PTB患者的家庭接触者进行结核病筛查。然而，关于沙沙马内镇PTB患者家庭接触者筛查依从性的信息尚无报道。
于2021年7月1日至11月30日开展了一项基于机构的混合方法横断面研究，连续选取了392例PTB患者和23名特意挑选的关键信息提供者。使用预先测试的由访谈员管理的问卷和引导性问题收集数据。使用SPSS 25版进行数据分析，并根据主题领域对深入访谈信息进行分析。进行双变量分析，随后进行95%置信区间的多变量逻辑回归分析。P值<0.05被认为可确定具有统计学意义的因素。
家庭接触者筛查（HHCS）的总体依从率为44.4%（95%置信区间：39.3，49.1）。接触时间少于15年（调整后比值比[AOR]=2.386，95%置信区间：1.44，3.96）、文凭及以上教育程度（AOR=3.43，95%置信区间：1.286，9.15）、良好的知识水平（AOR=2.999，95%置信区间：1.79，5.03）、积极的态度（AOR=2.409，95%置信区间：1.45，4.02）、接受健康教育（AOR=3.287，95%置信区间：1.92，5.63）以及PTB涂片阳性类型（AOR=2.156，95%置信区间：1.28，3.62）是与HHCS依从性显著相关的因素。从定性数据中还确定了工作量、机构准备情况和护理人员承诺等因素。
参照WHO和国家关于应对所有家庭接触者进行筛查的建议，我们研究中的HHCS依从性未达最佳水平。接触时间少于15年、教育程度、知识水平、态度、接受健康教育以及肺结核类型是与依从性相关的因素。我们建议提高社区对结核病的认识，为结核病患者及其家属提供健康教育，强化对家庭接触者筛查的积极态度，并加强卫生专业人员对家庭接触者筛查的承诺。
